OBSERVATIONS ON THE PATHOMORPHOLOGY OF THE THORACOLUMBAR FASCIA IN CHRONIC MECHANICAL BACK PAIN - A MICROSCOPIC STUDY

Study Design. Human tissue specimens were examined for the presence of neural end-organs under light and electron microscopy. Objectives. To define the innervation of the thoracolumbar fascia in problem back pa in patients who have articular abnormality defined through pain-provoc ation discography or facet blocks. Summary of Background Data. Previou s investigators have defined the presence of innervation in control (n o back pain) tissue specimens. Methods. Tissue specimens were harveste d during surgery from 24 back pain patients who had not undergone prev ious lumbar surgery. Specimens were fixed immediately in the operating room and later processed and studied under light and electron microsc opy. Results, Structural and ultrastructural studies failed to identif y specific neural end-organs in any of the specimens. Serendipidously, microscopic changes suggestive of ischemia or inflammation in this ti ssue were found. Conclusions. These findings suggest that the thoracol umbar fascia may be deficiently innervated in problem back pain patien ts.