Regional variations in the innervation of deep fasciae and aponeuroses

Stilwell, Donald L.

doi:10.1002/ar.1091270402

Cited by 57 publications

(23 citation statements)

References 11 publications

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“…At least four different types of nerve endings were observed in these ligaments. Consistent with earlier histologic studies, three of them could be readily characterized as Ruffini end organs, Ruffini corpuscles, and pacinian corpuscles (Boyd 1954, Stilwell 1956, 1957, Hromada and Polacek 1958, Jacksonetal. 1966,O'ConnorandGonzales 1979, Schultzet al 1984,Zimnyetal.…”

Section: Resultssupporting

confidence: 81%

“…Then, there are at least two potential sources innervating the posterior ligamentous system, that is, the lumbar dorsal rani and the sinuvertebral nerve. Stilwell (1956Stilwell ( , 1957 found the Ruffini receptors only at the connection between the spinalis dorsi and the interspinous ligament and the pacinian corpuscles only in the lumbodorsal fascia. We have now found them also in the supraspinous ligaments and the ligamenta flava.…”

Section: Discussionmentioning

confidence: 99%

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Neurohistology of lumbar spine ligaments

Yahia

Newman

Rivard

1988

Acta Orthopaedica Scandinavica

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Section: Resultssupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Neurohistology of lumbar spine ligaments

Yahia

Newman

Rivard

1988

Acta Orthopaedica Scandinavica

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“…Several studies revealed the presence of mechanosensory receptors in fascia [14,20,21,24]. In particular for the TLF, the presence of Ruffini's and Vater-Pacini corpuscles has been demonstrated [27].…”

Section: Transducer Function Of the Tlfmentioning

confidence: 99%

Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)

Schleip¹,

Vleeming²,

Lehmann‐Horn³

et al. 2007

Eur Spine J

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In his article Panjabi gives a concise overview on the current knowledge and understanding of low back and neck pain [12]. He introduces the hypothesis that chronic back pain originates from subfailure injuries of three types of spinal ligamentous structures and their embedded mechanoreceptors: namely the spinal ligaments, the disc annulus and the facet capsules. These injured tissues then send out corrupted transducer signals to the neuromuscular control unit, and as a result corrupted muscle response patterns are generated leading to adverse consequences such as higher stresses, muscle fatigue, further injuries, and inflammation.While paying less attention to the central learning processes involved in chronic back pain [5, 6,19], this model focuses mainly on the structural mechanisms of pain generation. We are appreciative about the value of the hypothesis within this structural field and are optimistic about its successful application to the understanding and treatment of many cases of back pain. While we agree with the basic hypothesis and its emphasis on the transducer (mechanosensory) function of ligamentous tissues, we suggest to refine the model in terms of an inclusion of the thoracolumbar fascia (TLF). We present evidence that the TLF is significantly involved in all three levels of the hypothesis concerning spinal ligamentous structures: the transducer function of these tissues, their structural spinal function, and their proneness for subfailure injuries.

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“…Electrophysiological studies in rats showed evidence of functional innervation of the paraspinal connective tissues of the sacrum [Bove and Light, 1995] and the thoracolumbar fascia [Taguchi et al, 2008]. Furthermore, some descriptive and immunohistochemical studies have reported that sensory nerves are present in the connective tissues of the low back [Stilwell, 1957;Yahia et al, 1992;Reinert et al, 1998], although others have not found innervation [Bednar et al, 1995]. A particular challenge to studying the innervation of connective tissue is that nerve fibers within connective tissue could be 'en passant' on their way to the skin or muscles, branching and/or terminating within the tissue itself [Bove and Light, 1995].…”

Section: Introductionmentioning

confidence: 99%

“…However, the techniques used in previously published histological studies were not specific for sensory nerve fibers and did not clearly demonstrate the presence of nerve fiber endings [Stilwell, 1957;Yahia et al, 1992;Bednar et al, 1995;Reinert et al, 1998]. For most studies, thin (4-6 m) tissue sections were used where it was not possible to distinguish between a true nerve ending and an ending that was cut as a result of tissue processing [Stilwell, 1957;Yahia et al, 1992;Reinert et al, 1998]. …”

Section: Introductionmentioning

confidence: 99%

Sensory Innervation of the Nonspecialized Connective Tissues in the Low Back of the Rat

Corey

Vizzard²,

Badger

et al. 2011

Cells Tissues Organs

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Chronic musculoskeletal pain, including low back pain, is a worldwide debilitating condition; however, the mechanisms that underlie its development remain poorly understood. Pathological neuroplastic changes in the sensory innervation of connective tissue may contribute to the development of nonspecific chronic low back pain. Progress in understanding such potentially important abnormalities is hampered by limited knowledge of connective tissue’s normal sensory innervation. The goal of this study was to evaluate and quantify the sensory nerve fibers terminating within the nonspecialized connective tissues in the low back of the rat. With 3-dimensional reconstructions of thick (30–80 µm) tissue sections we have for the first time conclusively identified sensory nerve fiber terminations within the collagen matrix of connective tissue in the low back. Using dye labeling techniques with Fast Blue, presumptive dorsal root ganglia cells that innervate the low back were identified. Of the Fast Blue-labeled cells, 60–88% also expressed calcitonin gene-related peptide (CGRP) immunoreactivity. Based on the immunolabeling with CGRP and the approximate size of these nerve fibers (≤2 µm) we hypothesize that they are Aδ or C fibers and thus may play a role in the development of chronic pain.

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Regional variations in the innervation of deep fasciae and aponeuroses

Cited by 57 publications

References 11 publications

Neurohistology of lumbar spine ligaments

Neurohistology of lumbar spine ligaments

Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)

Sensory Innervation of the Nonspecialized Connective Tissues in the Low Back of the Rat

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