The Anatomical Study and Clinical Significance of the Sinuvertebral Nerves at the Lumbar Levels

Abstract

Study Design. A dissection-based study of 10 embalmed human cadavers. Objective. The purpose of this study was to describe the sinuvertebral nerves at the lumbar level and to discuss their possible clinical significance. Summary of Background Data. Discogenic low-back pain is mediated by the sinuvertebral nerves. However, the detailed descriptions of the sinuvertebral nerves at the lumbar level are lacking. Methods. One hundred L1-L5 intervertebral foramina from 10 embalmed cadavers were studied. The presence of the sinuvertebral nerves was noted. The quantity, origin, pathway, innervation range, and spatial orientations of the sinuvertebral nerves in the L1-L5 intervertebral foramina were examined. Results. A total of 450 sinuvertebral nerves were identified in the 100 lumbar intervertebral foramina; sinuvertebral nerves were observed in 100.00% of the intervertebral foramina. The sinuvertebral nerves were routinely divided into the following two types: the sinuvertebral nerve deputy branch and sinuvertebral nerve main trunk. Three hundred twelve sinuvertebral nerve deputy branches were found; on average, there were approximately 3.12 (range, 1–8) branches in each intervertebral foramen. One hundred thirty-eight sinuvertebral nerve main trunks were found, and sinuvertebral nerve main trunks were observed in 97.00% of the intervertebral foramina. The initial portion of the sinuvertebral nerve was located along the posterior-lateral edge of the disc to the spinal canal. Sixty-one (44.20%) sinuvertebral nerve main trunks originated from the starting point of the gray ramus communicans of the nerve root; 77 (55.80%) sinuvertebral nerve main trunks originated from the anterior surface of the spinal ganglia of the nerve root. Conclusion. This is a systematic anatomy study that describes the sinuvertebral nerve at the lumbar level and may be of clinical importance to spinal surgeons. A comprehensive understanding of the distribution of sinuvertebral nerves may lead to significant benefits for patients undergoing percutaneous endoscopic treatment for discogenic low-back pain. Level of Evidence: 4

Basivertebral Nerve Ablation for the Treatment of Vertebrogenic Pain

“…They found that the nerves were adjacent to the blood vessels and that they enter posteriorly via the basivertebral foramen and cluster in the vertebral center. These sinuvertebral nerves, which likely accompany the nutrient artery into the vertebral body, are an important potential source and target for treatment [46]. This is in agreement with what was previously believed.…”

“…Zhao et al shed further light on the anatomy of the sinuvertebral nerves within the lumbar vertebrae [46]. The authors found that the sinuvertebral nerves divide into a deputy branch and main trunk.…”

“…The main trunks were nearly always found in the intervertebral foramina, and the initial portion was located along the posterolateral edge of the disc. As the anatomy of the lumbar vertebrae has only recently been uncovered, further studies should be done to corroborate this and to understand how we can implement this knowledge with regard to treatment [46].…”

Analysis of curative effect: percutaneous transforaminal endoscopic discectomy for lumbar disc herniation with buttock pain as the main symptom

“…(1) Removal of herniated nucleus pulposus: relieving mechanical compression and in ammatory stimulation of nerve roots. (2) Denervation of annulus brosus by bipolar electrocoagulation: Li et al (31) have shown that the SVN originates from the posterolateral edge of the intervertebral disc to the spinal canal, and the accessory branches of the SVN enter directly into the posterolateral margin of the intervertebral disc. Among them, 55.8% of the main trunk of the SVN originates from the spinal ganglion of the posterior root of the spinal nerve.…”

Use of Pulsed Radiofrequency for the Treatment of Discogenic Back Pain: A Narrative Review

“…In a normal intervertebral disc, sinuvertebral nerves are confined to the outer third of the annulus fibrosus 36 . However, in degenerated or injured discs, sinuvertebral nerves grow along a fissure or tear within discs 37 .…”