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In the case of combination of osteopoikilosis with dermal alterations we wanted to know if the hereby discussed general mesenchymal lesions are the cause of the additional entrapment syndromes of peripheral nerves present in our case. For this purpose we recorded the pressure at the distal median and ulnar nerves within and out of the entrapment location. The results of the pressure recording of not point to a primary nerve lesion by a elevated pressure susceptibility or a pressure elevation at the peripheral nerve out of a defined entrapment location e.g. by an increase of connective tissue. Because of a hypertrophic scar formation in this case it should be paid attention to the wound healing of all patients with osteopoikilosis. The histologically verified nevoid mesenchymal alterations of the connective tissue found in this case, are to be delineated from the disseminated lenticular dermatofibrosis of the Buschke-Ollendorff syndrome.

The important anatomical structures and the topographic relationships of lumbar disc surgery are described. Recent examinations about the epidural venous plexuses, the vascular supply of the spinal cord and nerve roots in the spinal canal enlarged our knowledge. Anterior and posterior spinal nerve roots differ in reaction to horizontally directed pull. The prevertebral anatomical structures which can be damaged by iatrogenic ventral perforation of the lumbar disc are demonstrated and their clinical importance is discussed.