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Innervation of "painful" lumbar discs. |
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AUTHORS: |
Coppes
MH; Marani E; Thomeer RT; Groen GJ |
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AUTHOR AFFILIATION: |
Department
of Neurosurgery, Groningen University, The Netherlands. |
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SOURCE: |
Spine
1997 Oct 15;22(20):2342-9; discussion 2349-50 |
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CITATION IDS: |
PMID:
9355214 UI: 98016834 |
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ABSTRACT: |
STUDY
DESIGN: The authors investigated the innervation of discographically
confirmed degenerated and "painful" human intervertebral discs.
OBJECTIVE: To determine the type and distribution patterns of nerve fibers
present in degenerated human intervertebral discs. SUMMARY OF BACKGROUND
DATA: The innervation of intervertebral discs has previously been
extensively described in fetal and adult animals as well as humans.
However, little is yet known about the innervation of severely degenerated
human lumbar discs. The question may be posed whether a disc that has been
removed for low back pain possesses an increased innervation compared with
normal discs. METHODS: The presence of nerve fibers was investigated using
acetylcholinesterase enzyme histochemistry, as well as neurofilament and
substance P immunocytochemistry. From 10 degenerated and 2 control discs,
the anterior segments were excised and their nerve distribution studied by
examining sequential sections. RESULTS: In all specimens, nerve fibers of
different diameters were found in the anterior longitudinal ligament and
in the outer region of the disc. In 8 of 10 degenerated discs, fibers were
also found in the inner parts of the disc. Substance P-immunoreactive
nerve fibers were sporadically observed in the anterior longitudinal
ligament and the outer zone of the anulus fibrosus. CONCLUSIONS: Findings
indicate a more extensive disc innervation in the severely degenerated
human lumbar disc compared with normal discs. The nociceptive properties
of at least some of these nerves are highly suggested by their substance P
immunoreactivity, which provides further evidence for the existence of a
morphologic substrate of discogenic pain. |
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MAIN MESH HEADINGS: |
Intervertebral
Disk/*innervation
Intervertebral Disk Displacement/*pathology
Low Back Pain/*surgery
Lumbar Vertebrae/*anatomy & histology |
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ADDITIONAL MESH HEADINGS: |
Acetylcholinesterase/analysis
Adult
Blood Vessels/pathology
DNA-Binding Proteins/analysis
Female
Human
Immunohistochemistry
Intervertebral Disk/chemistry
Intervertebral Disk/pathology
Lumbar Vertebrae/surgery
Male
Mechanoreceptors/immunology
Mechanoreceptors/pathology
Middle Age
Nerve Fibers, Myelinated/chemistry
Nerve Fibers, Myelinated/pathology
Nuclear Proteins/analysis
Substance P/analysis
Transcription Factors/analysis |
