La inervación del disco intervertebral

García-Cosamalón, José; Fernández-Fernández, Javier; González-Martínez, Emilio; Ibáñez-Plágaro, J.; Costales, Javier Robla; Martínez-Madrigal, Milton; Muñiz, Alfonso López; Soto, Miguel; Vega, J.A.

doi:10.1016/j.neucir.2012.03.002

Cited by 11 publications

(1 citation statement)

References 82 publications

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“…These processes are not only thought to incite a neuroinflammatory response that stimulates peptide containing nociceptive fibres [5] but also cause increased innervation to the inner annulus and nucleus pulposus with increased stimulation of segmental dorsal root ganglions (via sinuvertebral nerves) and paravertebral sympathetic fibres (Fig. 1) [678]. The loss of disc integrity and shock absorption capability from a dysfunctional disc is also thought to concurrently increase the biomechanical stress upon the facet joints [9].…”

Section: Introductionmentioning

confidence: 99%

Operative Management of Lumbar Degenerative Disc Disease

2016

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Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term.

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Section: Introductionmentioning

confidence: 99%

Operative Management of Lumbar Degenerative Disc Disease

2016

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Clinical anatomy of the lumbar sinuvertebral nerve with regard to discogenic low back pain and review of literature

et al. 2021

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Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43, 72.1%), common branch diverging into two branches (10/43, 23.3%), double ascending branch (1/43, 2.3%) finalizing two levels above and a descending branch (1/43, 2.3%). In 12/43 cases (27.9%) the SVN had ipsilateral connections with another SVN. The distribution ended in the middle of the vertebral body supplying adjacent structures. Conclusion A thorough understanding of the anatomy of the SVN might lead to significant benefits in therapy of discogenic low back pain. We suggest blocking the SVN at the level of the inferior vertebral notch of two adjacent segments. Level of evidence I Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding

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Epidemiology and Etiology of Discogenic Pain

Calodney¹,

Buchalter²

2012

Diagnosis, Management, and Treatment of Discogenic Pain

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La inervación del disco intervertebral

Cited by 11 publications

References 82 publications

Operative Management of Lumbar Degenerative Disc Disease

Operative Management of Lumbar Degenerative Disc Disease

Clinical anatomy of the lumbar sinuvertebral nerve with regard to discogenic low back pain and review of literature

Epidemiology and Etiology of Discogenic Pain

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