Full Text:

 

Ǵм Vol.24_No.2 Suppl. P.S203-211, Dec. 2007

Review

غ

Anatomy of Low Back Pain

輺ȣ, ȣ
б ǰ Űܰб
åڣ輺ȣ, 뱸 317-1, б ǰ Űܰб
Tel: (053) 620-3790, Fax: (053) 620-3770
E-mail: shkim@medical.yu.ac.kr

December 30, 2007

Abstract

The sinuvertebral nerve(SVN) supplies the laterodorsal outer annulus of the intervertebral disc, the posterior longitudinal ligament(PLL), the anterior 2/3 of the dural sac and the anterior vascular plexus. Many blood vessels pass through the lateral neural canal: the anterior and posterior spinal canal branches, anterior and posterior radicular branches, and veins of the anterior and posterior internal vertebral venous plexus. The PLL is assumed to play an important role in proprio- and nociception. In the neighborhood of the SVN, other small branches emanate from the rami communicantes and join the dorsal ramus and the segmental artery that enters the neural canal. The sympathetic nerve plexus inside the anterior longitudinal ligament and the SVNs provide a network of nerve fibers around the vertebral bodies and intervertebral discs. These pathways explain the sympathetic component of the innervation of a number of spinal structures. The dorsal ramus innervates the facet joints at the corresponding level and one below, before it gives off muscular and cutaneous branches.

Key Words: Low back pain, Sinuvertebral nerve, Sympathetic nerve

References

1. Andersson GB. Epidemiologic aspects on low- back pain in industry. Spine 1981 Jan-Feb;6 (1):53-60.

2. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990 Mar;72(3):403-8.

3. Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine 1995 Sep 1;20(17):1878-83.

4. Maroudas A, Stockwell RA, Nachemson A, Urban J. Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro. J Anat 1975 Sep;120(Pt 1):113-30.

5. Ko HY, Park BK. Facet tropism in lumbar motion segments and its significance in disc herniation. Arch Phys Med Rehabil 1997 Nov;78(11):1211-4.

6. Dory MA. Arthrography of the lumbar facet joints. Radiology 1981 Jul;140(1):23-7.

7. Lippitt AB. The facet joint and its role in spine pain. Management with facet joint injections. Spine 1984 Oct;9(7):746-50.

8. Carr D, Gilbertson L, Frymoyer J, Krag M, Pope M. Lumbar paraspinal compartment syndrome. A case report with physiologic and anatomic studies. Spine 1985 Nov;10(9):816-20.

9. Olmarker K, Rydevik B, Holm S, Bagge U. Effects of experimental graded compression on blood flow in spinal nerve roots. A vital microscopic study on the porcine cauda equina. J Orthop Res 1989;7(6):817-23.

10. Chen C, Cavanaugh JM, Ozaktay AC, Kallakuri S, King AI. Effects of phospholipase A2 on lumbar nerve root structure and function. Spine 1997 May 15;22(10):1057-64.

11. Kang JD, Georgescu HI, McIntyre-Larkin L, Stefanovic-Racic M, Donaldson WF, 3rd, Evans CH. Herniated lumbar intervertebral discs spontaneously produce matrix metallopro- teinases, nitric oxide, interleukin-6, and prostaglandin E2. Spine 1996 Feb 1;21(3):271-7.

12. Rydevik BL, Myers RR, Powell HC. Pressure increase in the dorsal root ganglion following mechanical compression. Closed compartment syndrome in nerve roots. Spine 1989 Jun;14 (6):574-6.

13. Rydevik B, Brown MD, Lundborg G. Pathoa- natomy and pathophysiology of nerve root compression. Spine 1984 Jan-Feb;9(1):7-15.

14. Spencer DL, Irwin GS, Miller JA. Anatomy and significance of fixation of the lumbosacral nerve roots in sciatica. Spine 1983 Sep;8(6): 672-9.

15. Groen GJ, Baljet B, Drukker J. The innervation of the spinal dura mater: anatomy and clinical implications. Acta Neurochir (Wien) 1988;92 (1-4):39-46.

16. Nakamura S, Takahashi K, Takahashi Y, Morinaga T, Shimada Y, Moriya H. Origin of nerves supplying the posterior portion of lumbar intervertebral discs in rats. Spine 1996 Apr 15;21(8):917-24.

17. Yamashita T, Cavanaugh JM, el-Bohy AA, Getchell TV, King AI. Mechanosensitive afferent units in the lumbar facet joint. J Bone Joint Surg Am 1990 Jul;72(6):865-70.

18. Bogduk N. The innervation of the lumbar spine. Spine 1983 Apr;8(3):286-93.