Document Detail

Innervation of "painful" lumbar discs.
MedLine Citation:
PMID:  9355214     Owner:  NLM     Status:  MEDLINE    
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.
M H Coppes; E Marani; R T Thomeer; G J Groen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  22     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-12-10     Completed Date:  1997-12-10     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2342-9; discussion 2349-50     Citation Subset:  IM    
Department of Neurosurgery, Groningen University, The Netherlands.
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MeSH Terms
Acetylcholinesterase / analysis
Blood Vessels / pathology
DNA-Binding Proteins / analysis
Intervertebral Disk / chemistry,  innervation*,  pathology
Intervertebral Disk Displacement / pathology*
Low Back Pain / surgery*
Lumbar Vertebrae / anatomy & histology*,  surgery
Mechanoreceptors / immunology,  pathology
Middle Aged
NFATC Transcription Factors
Nerve Fibers, Myelinated / chemistry,  pathology
Nuclear Proteins / analysis
Substance P / analysis
Transcription Factors / analysis
Reg. No./Substance:
0/DNA-Binding Proteins; 0/NFATC Transcription Factors; 0/Nuclear Proteins; 0/Transcription Factors; 33507-63-0/Substance P; EC

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