The motor roots and sensory roots of the lumbosacral nerve each penetrate the dura mater and are wrapped by the sheath of the dura mater, and meet at the distal end of the posterior root ganglion of the spinal nerve to form the spinal nerve. Compared with the peripheral nerves, the nerve roots are less elastic and lack chemical barrier function, and their ability to resist pulling, squeezing and chemical stimulation is reduced. The two systems coincide in the outer 1/3 of the nerve root, where the vascular network is underdeveloped and less tolerant to ischemia than the peripheral nerves, and prone to inflammation and edema. Therefore, the nerve root is more susceptible to impingement syndrome than the peripheral nerves and the cauda equina in the central spinal canal. Because nerve roots do not have the protective sheath of the peripheral nerve, they have a direct mechanical effect on the nerve and an indirect effect by impairing the blood supply to the nerve. Experimental evidence shows that ischemia has a greater effect on nerve conduction than pressure itself. Chronic irritation or mild mechanical compression of the nerve roots in the spinal canal causes stagnation of microvenules and capillaries, causing accumulation of metabolites in the nerve tissue, which can lead to pain and numbness, clinically dominated by radiating pain. Prolonged compression or tremendous compression causes chronic damage to the nerve root, edema and secondary fibrosis within the nerve, resulting in significant loss of function of the nerve root, which is the reason why some patients recover very slowly or even not easily after the nerve root compression is lifted.
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