Nerve Endings in the Human Lumbar Spinal Column and Related Structures

Jackson, Henry C.; Winkelmann, R. K.; Bickel, William H.

doi:10.2106/00004623-196648070-00002

Cited by 203 publications

(49 citation statements)

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“…Such postures have been shown to increase a person's probability of developing degenerative disk disorders [27] and lumbar disc herniation [28]. Prolonged lumbar flexion is also thought to elevate low back discomfort through increased loading of the passive tissues of the lumbar spine [29], tissues which are highly innervated with nociceptors [30,31,32]. The ability to maintain lumbar lordosis while minimizing peak pressures on the lumbar spine are important for decreasing low back discomfort [12,13].…”

Section: Discussionmentioning

confidence: 99%

The Effect of an Active Lumbar System on the Seating Comfort of Officers in Police Fleet Vehicles

Donnelly

Callaghan

Durkin

2009

International Journal of Occupational Safety and Ergonomics

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Section: Discussionmentioning

confidence: 99%

The Effect of an Active Lumbar System on the Seating Comfort of Officers in Police Fleet Vehicles

Donnelly

Callaghan

Durkin

2009

International Journal of Occupational Safety and Ergonomics

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“…Biomechanical studies have demonstrated endplate deformation during discography [11]. Abnormalities of the endplates and adjacent marrow may stimulate elements of the sympathetic nervous system [1,2,14]. Clinically, direct endplate manipulation and discographic loading of disrupted endplates has been associated with concordant pain symptoms [6,13,18,29].…”

Section: Discussionmentioning

confidence: 99%

Vertebral body MRI related to lumbar fusion results

et al. 1997

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The evaluation of continued pain after a technically successful posterolateral lumbar spine fusion is often challenging. Although the intervertebral disc is often a source of low back pain, abnormal endplates may also be a focus of pain, and possibly a source of continued pain after a posterolateral fusion. MRI allows noninvasive evaluation for disc degeneration, as well as for abnormal endplates and adjacent vertebral body marrow. Previous studies have found inflammatory marrow changes, adjacent to abnormal endplates, associated with disc degeneration in low back pain patients. In this study, preoperative MRI scans in 89 posterolateral lumbar fusion patients were reviewed, by an independent radiologist, to determine whether vertebral body marrow changes adjacent to the endplates were related to contined pain. Independent chart review and follow-up telephone interview of all patients at a 4-year follow-up (mean) formed the basis for the clinical results. Vertebral body MRI signals consistent with inflammatory or fatty changes were found in 38% of patients, and always occurred adjacent to a degenerated disc. Inflammatory MRI vertebral body changes were significantly related to continued low back pain at P = 0.03. We conclude that posterolateral lumbar fusion has a less predictable result for the subset of degenerative disc patients with abnormal endplates and associated marrow inflammation. More research is needed to determine the biological and biomechanical effects of a posterolateral fusion upon the endplate within the fused segments. If indeed further study supports the hypothesis that abnormal endplates associated with inflammation are a source of pain, then treating the endplates directly by anterior fusion may be a preferred treatment for this subset of degenerative patients.

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“…It is less certain whether the ligamentum flavum, which forms the ventral portion of the joint capsule, is innervated. Hirsch et al (1963) and Ramsey (1966) identified a small number of free neural structures described as nerve endings, but Jackson et al (1966) could not find any nerve endings. The question of innervation of the synovial membrane is even more contentious.…”

mentioning

confidence: 98%