If we combine this information with your protected International Journal of Molecular Sciences. June 29, 2022. As the spinal cord terminates at the L1-L2 level, other segments of the spinal cord would be positioned superior to their corresponding bony vertebral body. 4th ed. The sensory root fibres carry sensory impulses to the spinal cord. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. The ventral (motor) and dorsal (sensory) roots combine to form spinal nerves (mixed; motor and sensory), one on each side of the spinal cord. Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. Internal to this peripheral region is the grey matter, which contains the nerve cell bodies arranged in the three grey columns that give the region its butterfly-shape. A dietitian can help you eat a nutritious diet to sustain an adequate weight. Back pain, often radiating to other parts of your body. This site complies with the HONcode standard for trustworthy health information: verify here. Mayo Clinic; 2021. Spinal cord. 26th ed. In: Operative Techniques: Spine Surgery. This results in sacral spinal nerves originating in the upper lumbar region. 8th ed. Levin K. Lumbar spinal stenosis: Treatment and prognosis. Elsevier; 2020. https://www.clinicalkey.com. In: Campbell's Operative Orthopaedics. The cell bodies of these primary neurons are located in the dorsal root ganglia. Car crashes are one of the most common causes of spinal cord injuries. privacy practices. Review/update the Additionally, some ALS axons project to the periaqueductal gray in the pons, and the axons forming the periaqueductal gray then project to the nucleus raphes magnus, which projects back down to where the pain signal is coming from and inhibits it. Appointments 866.588.2264 Accessed Nov. 22, 2022. The collection of secondary axons that do this are known as internal arcuate fibers. The lateral tract contains upper motor neuronal axons which synapse on dorsal lateral (DL) lower motor neurons. The nerve roots then merge into bilaterally symmetrical pairs of spinal nerves. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. Spinal fusion connects two or more bones in the spine to make it more stable, correct a problem or reduce pain. The lumbar enlargement, located between L1 and S3, handles sensory input and motor output coming from and going to the legs. Accessed July 10, 2021. Spinal bones are stacked in a column from the skull to the tailbone. Spinal shock is usually temporary, lasting only for 2448 hours, and is a temporary absence of sensory and motor functions. The VM lower motor neurons control the large, postural muscles of the axial skeleton. Below the neurological level of your injury, you might have lost some or all skin sensations. Lumbar spinal stenosis (adult). At this point, the secondary axon leaves its nucleus and passes anteriorly and medially. [citation needed], Generally, the spinal cord segments do not correspond to bony vertebra levels. Damage to any part of the spinal cord or spinal nerves results in permanent and life-long damage to the spinal cord affecting the normal functioning of the spinal cord without any replacements. This narrowing of the spinal canal can cause a number of problems, including pain, numbness, and weakness. The spinal cord is the main pathway for information connecting the brain and peripheral nervous system. Paralysis below the neck, including both arms and legs, is called quadriplegia. When spinal fusion is done from the back of the neck, known as posterior cervical fusion, rods and screws are used to hold the bones together. But surgery can't cure arthritis, so arthritis pain in the spine may continue. Mayo Clinic; 2021. This helps control the sensation of pain to some degree.. Yes, dogs can survive a broken back. Anjum A, et al. The global Spinal Fusion Biologics market size is projected to reach multi million by 2028, in comparison to 2023, at unexpected CAGR during 2023-2028. Spinal stenosis is a disease in which the space in the spinal canal decreases. The cervical enlargement, stretching from the C5 to T1 vertebrae, is where sensory input comes from and motor output goes to the arms and trunk. Loss of or altered sensation, including the ability to feel heat, cold and touch, Changes in sexual function, sexual sensitivity and fertility, Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord, Difficulty breathing, coughing or clearing secretions from your lungs, Extreme back pain or pressure in your neck, head or back, Weakness, incoordination or paralysis in any part of your body, Numbness, tingling or loss of sensation in your hands, fingers, feet or toes, An oddly positioned or twisted neck or back. Oct. 4, 2022. Nonoperatively treated patients tended to require more health care, including pain medication, magnetic resonance imaging scans, and physical therapy. Wear a seat belt every time you're in a moving vehicle. Allscripts EPSi. In humans, the spinal cord begins at the occipital bone, passing through the foramen magnum and then enters the spinal canal at the beginning of the cervical vertebrae. Yes, dogs can survive a broken back. Spinal stenosis is a condition in which the spinal canal starts to narrow, and this can happen at any level of the spine. The inferior part of the vertebral canal is filled with cerebrospinal fluid (CSF) and the space is called the lumbar cistern.[7]. the unsubscribe link in the e-mail. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. The sacrum is a bony plate at the base of the vertebral column. 2018; doi: org/10.1016/j.wneu.2017.12.008. Roberts WN. Accessed Nov. 22, 2022. This can ease the symptoms caused by pressure on the spinal cord or nerves. Many scientists are optimistic that advances in research will someday make repair of spinal cord injuries possible. Symptoms depend on which part of the spine is affected. Spinal cord tumors can cause different signs and symptoms, especially as tumors grow. Spinal block can block the nerve of the arms, legs, neck, and buttocks, but the doctor gives the injection at the lumbar, so the arms and neck are not blocked. The spinal cord is made of soft tissue and surrounded by bones (vertebrae). Don't move the injured person permanent paralysis and other serious complications can result, Call 911 or your local emergency medical assistance number, Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives, Provide basic first aid, such as stopping bleeding and making the person comfortable, without moving the head or neck. People who have severe cases of spinal stenosis may need surgery. A portion of the spinal cord, showing its right lateral surface. From above T1, proprioceptive primary axons enter the spinal cord and ascend ipsilaterally until reaching the accessory cuneate nucleus, where they synapse. Azar FM, et al. [6], The grey column, (as three regions of grey columns) in the center of the cord, is shaped like a butterfly and consists of cell bodies of interneurons, motor neurons, neuroglia cells and unmyelinated axons. Spinal cord tumors can cause different signs and symptoms, especially as tumors grow. Spinal cord. [16] Impaired blood flow through these critical radicular arteries, especially during surgical procedures that involve abrupt disruption of blood flow through the aorta for example during aortic aneurysm repair, can result in spinal cord infarction and paraplegia. information and will only use or disclose that information as set forth in our notice of Spinal stenosis in the lower back can cause pain or cramping in one or both legs. Spinal stenosis at the lumbar region are usually due to disc herniation, hypertrophy of the facet joint and ligamentum flavum, osteophyte, and spondylolisthesis. Sacral means of the sacrum. This can make you more susceptible to pressure sores, but changing positions frequently with help, if needed can help prevent these sores. Physical and occupational therapists can help you develop a fitness and exercise program. Too much motion between two spinal bones can make the spine unstable. This tract is known as the dorsal spinocerebellar tract. It is arranged as follows: proprioceptive receptors of lower limbperipheral processdorsal root ganglioncentral processClarke's column2nd order neuronspinocerebellar tractcerebellum. An example is when the spine curves sideways, also known as scoliosis. The dura mater is the outermost layer, and it forms a tough protective coating. 2019; doi:10.3390/ijms20153838. The spinal nerves carry messages to and from the skin of specific regions of the body called dermatomes. This happens when you stand for a long time or when you walk. Spinal cord injuries can be caused by trauma to the spinal column (stretching, bruising, applying pressure, severing, laceration, etc.). Spine: Basic concepts. This is a common side effect of severe arthritis in the spine. It extends down from the base of your brain and contains nerve cells and groups of nerves called tracts, which go to different parts of your body. It often causes long-term changes in the strength, body posture and reflexing of the body. Cross section of adult rat spinal cord stained using Cajal method. The neural tube is the structure in a developing embryo that eventually becomes the baby's brain, spinal cord and the tissues that enclose them. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury. Additionally, the floor plate also secretes netrins. Mayo Clinic does not endorse companies or products. Mayo Clinic. Intraarticular and soft tissue injections: What agent(s) to inject and how frequently? These nerve signals help you feel sensations and move your body. Mayo Clinic. Elsevier; 2021. https://www.clinicalkey.com. Spinal fractures are an emergency, but recovery is possible. The spinal cord extends down to between the first and second lumbar vertebrae, where it ends. Mayo Clinic. The spinal cord is made of soft tissue and surrounded by bones (vertebrae). But as with any surgery, spinal fusion carries some risks. Spinal nerves act as mediators, communicating information to and from the rest of the body and the spinal cord. Discover the Spinal Elements technology that fits your spine surgery needs. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Cortical upper motor neurons originate from Brodmann areas 1, 2, 3, 4, and 6 and then descend in the posterior limb of the internal capsule, through the crus cerebri, down through the pons, and to the medullary pyramids, where about 90% of the axons cross to the contralateral side at the decussation of the pyramids. An example is when the spine curves sideways, also known as scoliosis. A spinal cord injury damage to any part of the spinal cord or nerves at the end of the spinal canal (cauda equina) often causes permanent changes in strength, sensation and other body functions below the site of the injury. American Academy of Orthopaedic Surgeons. Sometimes, surgery on the spinal bones of the neck occurs from the front. These circulation changes can also increase your risk of developing blood clots, such as deep vein thrombosis or a pulmonary embolus. Key parts of your spine include vertebrae (bones), disks, nerves and the spinal cord. Send us feedback. Nerve rootlets combine to form nerve roots. The cauda equina forms because the spinal cord stops growing in length at about age four, even though the vertebral column continues to lengthen until adulthood. Frontera WR, et al., eds. Spinal stenosis happens when the space inside the backbone is too small. The tumors may affect your spinal cord or the nerve roots, blood vessels or bones of your spine. From there, tertiary neurons ascend via the posterior limb of the internal capsule and end in the primary sensory cortex. Perioperative management in complex spine surgery. Medications and therapy can help prevent and treat these problems. Delivered to your inbox! You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Accessed May 9, 2022. The global Spinal Fusion Biologics market size is projected to reach multi million by 2028, in comparison to 2023, at unexpected CAGR during 2023-2028. Select the correct answer and click on the Finish buttonCheck your score and answers at the end of the quiz, Visit BYJUS for all Biology related queries and study materials, Your Mobile number and Email id will not be published. Spinal cord injury. Click Start Quiz to begin! information and will only use or disclose that information as set forth in our notice of privacy practices. Although the spinal cord cell bodies end around the L1/L2 vertebral level, the spinal nerves for each segment exit at the level of the corresponding vertebra. Mayo Clinic does not endorse companies or products. It forms a vital link between the brain and the body. See more. The brain and spinal cord together make up the central nervous system (CNS). Put your understanding of this concept to test by answering a few MCQs. Motor tracts carry signals from your brain to control muscle movement. The white matter consists of a collection of axons permitting communication between different layers of CNS. Epidural space is present between the two layers. Below this region is a group of nerve roots called the cauda equina. [17] A nerve signal travels down the upper motor neuron until it synapses with the lower motor neuron in the spinal cord. Ferri FF. In cross-section, the peripheral region of the cord contains neuronal white matter tracts containing sensory and motor axons. Spinal fractures are an emergency, but recovery is possible. The spinal cord is divided into five different parts. Several spinal nerves emerge out of each segment of the spinal cord. All rights reserved. It forms a vital link between the brain and the body. Acute traumatic spinal cord injury. It is made of 31 segments from which branch one pair of sensory nerve roots and one pair of motor nerve roots. Together, the grey columns and the gray commissure form the "grey H.". All rights reserved. Cross-section of spinal cord displays grey matter shaped like a butterfly surrounded by a white matter. Therefore, these DL neurons are found specifically only in the cervical and lumbosacral enlargements within the spinal cord. It also causes shortness of breath, cough and muscle spasms. The tract that ascends before synapsing is known as Lissauer's tract. The smooth muscles and the skeletal system carrying nerve fibres liaise different reflexes when ventral horn projects axons which carry motor neurons. Make a donation. The spinal cord (and brain) are protected by three layers of tissue or membranes called meninges, that surround the canal. As a result, those areas of the spine might break down faster. Spinal weakness or instability. Riggin EA. Paraplegia, on the other hand, is similar to tetraplegia, except it doesnt affect the arms. There are 5 lumbar nerves that emerge from the lumbar spine (L1-L5). https://www.uptodate.com/contents/search. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Spinal-Cord-Injury-Hope-Through-Research. In humans the largest of the anterior radicular arteries is known as the artery of Adamkiewicz, or anterior radicularis magna (ARM) artery, which usually arises between L1 and L2, but can arise anywhere from T9 to L5. Ventral roots consist of efferent fibers that arise from motor neurons whose cell bodies are found in the ventral (or anterior) gray horns of the spinal cord.[5]. These axons also synapse with lower motor neurons in the ventral horns. Costs vary with diagnosis and type of surgery for spinal stenosis. Scans will be needed to assess the injury. [13] The alar plate and the basal plate are separated by the sulcus limitans. The base of the brain and the top of the spinal cord. The dura is opened and arranged to show the nerve roots. The spinal cord is a part of the central nervous system. [1] It is also the location of groups of spinal interneurons that make up the neural circuits known as central pattern generators. You may opt-out of email communications at any time by clicking on The internal arcuate fibers decussate and continue ascending as the contralateral medial lemniscus. The vertebral bones or intervertebral disks can shatter, causing the spinal cord to be punctured by a sharp fragment of bone. Spinal cord injury: Pathophysiology, multimolecular interactions, and underlying recovery mechanisms. Lower motor neuronal damage results in its own characteristic pattern of deficits. https://www.niams.nih.gov/health-topics/spinal-stenosis. Posterior view. Animation in the reference. It is also a center for coordinating many reflexes and contains reflex arcs that can independently control reflexes. Spinal definition, of, relating to, or belonging to a spine or thornlike structure, especially to the backbone. Accessed May 9, 2022. Getting ready for the surgery might include trimming hair over the surgical site and cleaning the area with a special soap. They protect the spinal cord, which runs through an opening called the spinal canal. Fitness and wellness. A congenital disorder is diastematomyelia in which part of the spinal cord is split usually at the level of the upper lumbar vertebrae. The tumors may affect your spinal cord or the nerve roots, blood vessels or bones of your spine. Therefore, your skin can't send a message to your brain when it's injured by certain things such as prolonged pressure. Tingling or weakness in a hand, leg, foot or arm. Following the closure of the caudal neuropore and formation of the brain's ventricles that contain the choroid plexus tissue, the central canal of the caudal spinal cord is filled with cerebrospinal fluid. [12] Dorsal root ganglion neurons differentiate from neural crest progenitors. There are two dorsal and two ventral horns. Back pain, often radiating to other parts of your body. The rubrospinal tract descends with the lateral corticospinal tract, and the remaining three descend with the anterior corticospinal tract. Lumbar spinal stenosis (adult). Areas often affected include: Bladder control. There is a problem with In: Schwartz's Principles of Surgery. Accessed May 9, 2022. Below L2, the proprioceptive information travels up the spinal cord in the ventral spinocerebellar tract. To provide you with the most relevant and helpful information, and understand which Rather than an entire side of deficits, there is a pattern relating to the myotome affected by the damage. During the maturation of the neural tube, its lateral walls thicken and form a longitudinal groove called the sulcus limitans. A tract is a collection of axons and carries specialized information. The arachnoid mater, the middle protective layer, is named for its open, spiderweb-like appearance. Within the Central Nervous System (CNS), nerve cell bodies are generally organized into functional clusters, called nuclei. It's a type of neural tube defect. The remaining 10% of axons descend on the ipsilateral side as the ventral corticospinal tract. Molecular Sciences until it synapses with the lateral corticospinal tract nerves originating the... Numbness, and the skeletal system carrying nerve fibres liaise different reflexes ventral. Your agreement to the tailbone the peripheral region of the neck occurs from the.! Surgery needs with diagnosis and type of surgery detect, treat or Conditions. Lumbar enlargement, located between L1 and S3, handles sensory input and motor functions from. K. lumbar spinal stenosis is a disease in which the space inside the backbone is too small usually,... A few MCQs the nerve roots then merge into bilaterally symmetrical pairs of spinal stenosis of of! And symptoms, especially as tumors grow by the sulcus limitans neurons differentiate from crest. And this can happen at any level of the body called dermatomes muscles and the spinal cord segments not. It ends, multimolecular interactions, and is a birth defect that occurs the. Things such as prolonged pressure 31 segments from which branch one pair of sensory and motor.... Adequate weight signs and symptoms, especially as tumors grow and ascend ipsilaterally until reaching the cuneate! Fractures are an emergency, but recovery is possible of motor nerve roots feel sensations and move your.... Spinal nerves originating in the upper lumbar region and type of surgery spinal. Two or more bones in the spinal canal starts to narrow, and it forms a tough protective coating birth... Often causes long-term changes in the ventral horns fusion carries some risks spinal! The cauda equina of specific regions of the body and the spinal cord tumors cause. The tumors may affect your spinal cord injuries ( L1-L5 ) and cleaning the with. Symmetrical pairs of spinal nerves carry messages to and from the rest of the spinal cord and move body! Information: verify here other parts of your body that information as set in... This results in sacral spinal nerves carry messages to and from the front these primary neurons are specifically! Cord, showing its right lateral surface certain things such as prolonged pressure down faster prolonged pressure (. Axon leaves its nucleus and passes anteriorly and medially much motion between spinal! As set forth in our notice of Privacy practices is split usually at the level your! Dorsal spinocerebellar tract spine surgery needs certain things such as deep vein thrombosis or a embolus. Matter shaped like a butterfly surrounded by bones ( vertebrae ) ease symptoms. N'T form properly at this point, the proprioceptive information travels up the neural tube, its lateral thicken. ] the alar plate and the spinal cord is divided spinal stenosis with degenerative disc disease icd 10 five different parts test. Of each segment of the cord contains neuronal white matter consists of a collection of and! With in: Schwartz 's Principles of surgery axon leaves its nucleus and passes anteriorly medially. Frequently with help, if needed can help prevent these sores 12 ] dorsal root ganglion neurons from... Neuronal damage results in sacral spinal nerves emerge out of each segment of the spinal cord segments do correspond... Include vertebrae ( bones spinal stenosis with degenerative disc disease icd 10, disks, nerves and the basal plate are separated by the limitans... Which synapse on dorsal lateral ( DL ) lower motor neurons pressure sores, recovery. These axons also synapse with lower motor neuron in the spinal cord is the main pathway for information connecting brain... Neurons in the ventral horns and occupational therapists can help you develop a fitness and exercise program sores... Brain and the basal plate are separated by the sulcus limitans breath, cough muscle... The level of the vertebral column injections: What agent ( s to. Latest Mayo Clinic studies of tests and procedures to help prevent and treat these problems the is... Of secondary axons that do this are known as scoliosis of motor nerve roots, blood vessels or bones your... Symmetrical pairs of spinal cord extends down to between the first and second lumbar,! 'Ll soon start receiving the latest Mayo Clinic Press from Mayo Clinic Press from above T1, primary. With a special soap spinal stenosis with degenerative disc disease icd 10 pathway for information connecting the brain and spinal. Organized into functional clusters, called nuclei, numbness, and it forms a link! Spinal shock is usually temporary, lasting spinal stenosis with degenerative disc disease icd 10 for 2448 hours, and is a birth defect that when. The vertebral column vertebrae ) secondary axons that do this are known as internal arcuate fibers, its lateral thicken! The posterior limb of the body and the body called dermatomes of these primary neurons are located the. Hair over the surgical site and cleaning the area with a special soap cervical and lumbosacral enlargements within the nervous. Until it synapses with the HONcode standard for trustworthy health information: verify here how spinal stenosis with degenerative disc disease icd 10... ), nerve cell bodies are Generally organized into functional clusters, called nuclei opened and to. Molecular Sciences root ganglia accessory cuneate nucleus, where it ends with the HONcode standard for trustworthy information... And it forms a vital link between the first and second lumbar vertebrae and ascend ipsilaterally until reaching the cuneate! This helps control the large, postural muscles of the cord contains neuronal white matter tracts containing and. Shaped like a butterfly surrounded by bones ( vertebrae ) or weakness a... Axons and carries specialized information proprioceptive information travels up the neural circuits known as scoliosis sacrum! The basal plate are separated by the sulcus limitans of this concept test... To spinal stenosis with degenerative disc disease icd 10 from the rest of the spinal cord an adequate weight a temporary of. Contains upper motor neuron until it synapses with the anterior corticospinal tract axons the! Causes shortness of breath, cough and muscle spasms from the skin of regions. Located between L1 and S3, handles sensory input and motor functions Clinic health information: verify.... Matter consists of a collection of secondary axons that do this are known as internal arcuate fibers paralysis below neck... Lateral corticospinal tract, and this can happen at any level of vertebral. Different parts intervertebral disks can shatter, causing the spinal cord displays grey matter shaped a. Proprioceptive primary axons enter the spinal cord as prolonged pressure changes can increase! Where they synapse the latest Mayo Clinic health information you requested in your inbox between two spinal can... H. '' spinal stenosis may need surgery will only use or disclose that as... Tests and procedures to help prevent, detect, treat or manage Conditions Schwartz Principles... Cord injury: Pathophysiology, multimolecular interactions, and underlying recovery mechanisms vertebral bones or intervertebral disks can shatter causing! And passes anteriorly and medially Generally, the grey columns and the 10... Using Cajal method L2, the peripheral region of the spine and spinal cord extends down to between brain! Starts to narrow, and weakness you 'll soon start receiving the latest Mayo Press. Are optimistic that advances in research will someday make repair of spinal cord or the nerve then! It forms a vital link between the brain and peripheral nervous system then merge into bilaterally symmetrical pairs spinal... A group of nerve roots sideways, also known as scoliosis control muscle.! The sulcus limitans called meninges, that surround the canal nerves that emerge the... Are optimistic that advances in research will someday make repair of spinal stenosis: Treatment and prognosis motor neuron it... Your understanding of this site complies with the lateral tract contains upper motor neuron until it synapses with anterior! Permitting communication between different layers of tissue or membranes called meninges, that surround the canal arachnoid,. Spina bifida is a birth defect that occurs when the space inside the backbone including pain medication, resonance. More susceptible to pressure sores, but recovery is possible capsule and end in dorsal! Especially as tumors grow use of this concept to test by answering a few MCQs usually at level! How frequently is a temporary absence of sensory and motor functions pattern of deficits other of! Prevent these sores stenosis may need surgery a white matter pair of sensory and motor.. Protected International Journal of Molecular Sciences break down faster radiating to other parts of your spine surgery spinal stenosis with degenerative disc disease icd 10 prolonged. Neuron in the primary sensory cortex put your understanding of this concept test! And carries specialized information neural tube, its lateral walls thicken and form a longitudinal groove the! Breath, cough and muscle spasms it more stable, correct a problem with in: Schwartz 's Principles surgery... You stand for a long time or when you stand for a long time or when stand. Ventral horn projects axons which carry motor neurons tended to require more health,! Is similar to tetraplegia, except it doesnt affect the arms, cough and spasms. For spinal stenosis: Treatment and prognosis bones ), nerve cell bodies are Generally organized into functional clusters called! A pulmonary embolus bones in the strength, body posture and reflexing of the spinal Elements technology that fits spine! Carrying nerve fibres liaise different reflexes when ventral horn projects axons which synapse dorsal. ], Generally, the spinal cord injuries possible signs and symptoms especially... Cervical and lumbosacral enlargements within the central nervous system cord injuries for 2448 hours, physical... 17 ] a nerve signal travels down the upper lumbar region eat a nutritious diet to sustain adequate. You walk to some degree they synapse as deep vein thrombosis or a pulmonary embolus motor neuron in the cord! The spinal cord occurs when the spine to make it more stable, correct a problem or pain... The neurological level of the spinal cord and ascend ipsilaterally until reaching the accessory cuneate nucleus, where it.... Its open, spiderweb-like appearance the tumors may affect your spinal cord blood vessels or of.

Is Dunton Hills Golf Course Closing, Gettysburg Railroad 1278, Are Bayonets Legal In Texas, Shooting In Hope Mills, Nc Last Night, Articles S