K. Suseki et al., SENSORY NERVE-FIBERS FROM LUMBAR INTERVERTEBRAL DISCS PASS THROUGH RAMI COMMUNICANTES - A POSSIBLE PATHWAY FOR DISCOGENIC LOW-BACK-PAIN, Journal of bone and joint surgery. British volume, 80B(4), 1998, pp. 737-742
It has been thought that lumbar intervertebral discs were innervated s
egmentally. We have previously shown that the L5-L6 intervertebral dis
c in the rat is innervated bilaterally from the L1 and L2 dorsal root
ganglia through the paravertebral sympathetic trunks, but the pathways
between the disc and the paravertebral sympathetic trunks were unknow
n. We have now studied the spines of 17 rats to elucidate the exact pa
thways. We examined serial sections of the lumbar spine using immunohi
stochemistry for calcitonin gene-related peptide, a sensory nerve mark
er. We showed that these nerve fibres from the intervertebral disc ran
through the sinuvertebral nerve into the rami communicantes, not into
the corresponding segmental spinal nerve. In the rat, sensory informa
tion from the lumbar intervertebral discs is conducted through rami co
mmunicantes. If this innervation pattern applies to man, simple decomp
ression of the corresponding nerve root will not relieve discogenic pa
in. Anterior interbody fusion, with the denervation of rami communican
tes, may be effective for such low back pain.