Morphological basis for back pain: The demonstration of nerve fibers and neuropeptides in the lumbar facet joint capsule but not in ligamentum flavum

Ashton, I. K.; Ashton, Brian A.; Gibson, Susan E.; Polak, Julia M.; Jaffray, David; Eisenstein, Stephen M.

doi:10.1002/jor.1100100109

Cited by 153 publications

(55 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These include reactions in inflammatory joint diseases [2,42], fracture healing [3], disc herniations [36] and degeneration [6]. However, some structures, like the coracoacromial ligament [24] and ligamentum flavum [4], lack innervation and are therefore not likely to be involved in neurogenic inflammation or in pain perception.…”

Section: Introductionmentioning

confidence: 99%

Neurokinin 1‐receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus Studies on tennis elbow and medial epicondylalgia

Ljung

Alfredson

Forsgren

2004

Journal Orthopaedic Research

130

View full text Add to dashboard Cite

There is no information on the sensory innervation at the flexor muscle origin at the medial epicondyle of the humerus and it is not known if substance P receptors (Neurokinin I-receptors, NKI-R) are present in tendon insertions in general. In the present investigation, we have studied the muscle origin in patients suffering from medial epicondylalgia and tennis elbow. Immunohistochemistry and antibodies to substance P (SP) and CGRP as well as the general nerve marker PGP 9.5 were used. Specific immunoreactions were observed in nerve bundles and as free nerve fibers. The immunoreactive structures were partly seen in association with some of the blood vessels. The observations constitute a morphological correlate for the occurrence of nerve mediated effects in this region. By using immunohistochemistry and antibodies to NKI-R, the distribution of this receptor was studied at the insertion of the proximal tendon of the extensor carpi radialis brevis muscle at the lateral epicondyle. Specific immunoreactions were seen as varicose fibers occurring as single fibers or grouped into bundles, indicating that SP has effects in the nerves in this region. The results give further evidence for a possible neurogenic involvement in the pathophysiology of tennis elbow and in medial epicondylalgia.

show abstract

Section: Introductionmentioning

confidence: 99%

Neurokinin 1‐receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus Studies on tennis elbow and medial epicondylalgia

Ljung

Alfredson

Forsgren

2004

Journal Orthopaedic Research

130

View full text Add to dashboard Cite

show abstract

“…They were processed by the indirect avidin-biotin complex technique using biotinylated goat anti-rabbit IgG (Vector Laboratories, Burlingame, California), avidin biotin reagent (Vector Laboratories) and diaminobenzidine with ammonium nickel sulphate. 16 After each step, the slides were washed twice in 0.01 M PBS.…”

Section: Methodsmentioning

confidence: 99%

Sensory nerve fibres from lumbar intervertebral discs pass through rami communicantes

Suseki¹,

Takahashi²,

Takahashi³

et al. 1998

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

It has been thought that lumbar intervertebral discs were innervated segmentally. We have previously shown that the L5-L6 intervertebral disc 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 unknown.We have now studied the spines of 17 rats to elucidate the exact pathways. We examined serial sections of the lumbar spine using immunohistochemistry for calcitonin gene-related peptide, a sensory nerve marker. 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 information from the lumbar intervertebral discs is conducted through rami communicantes. If this innervation pattern applies to man, simple decompression of the corresponding nerve root will not relieve discogenic pain. Anterior interbody fusion, with the denervation of rami communicantes, may be effective for such low back pain. [Br] 1998;80-B:737-42. J Bone Joint Surg Received 4 August 1997; Accepted after revision 8 January 1998Lumbar intervertebral discs and facet joints are possible sources of low back pain, 1-3 but they have been considered to have a segmental sensory innervation. Recent studies in rats, however, have shown that the L5-L6 disc and part of the L5-L6 joint capsules are innervated by sensory neurones of the L1 and L2 dorsal root ganglia through the paravertebral sympathetic trunk, 4-10 although the fibre pathways between the disc and the sympathetic trunk are not known. Many reports have described fibres connecting the sinuvertebral nerve from the disc to rami communicantes tethered to the paravertebral sympathetic trunk, but they were thought to be sympathetic postganglionic nerve fibres. [11][12][13][14][15] Connections through the sinuvertebral nerve between the intervertebral disc and the rami communicantes have not yet been identified. We have investigated the distribution and course of both sensory and sympathetic postganglionic nerve fibres to the lumbar intervertebral disc in rats, using immunohistochemical methods. We paid special attention to the connections with rami communicantes and the segmentally corresponding spinal nerve. Materials and MethodsWe anaesthetised 17 Sprague-Dawley rats at 0 to 7 days after birth by cooling to 4°C. They were then transcardially perfused with 0.9% saline, followed by 100 ml of 4% paraformaldehyde in 0.1 M phosphate buffer (pH 7.4). The spinal column with its muscles from T13 to S1 was removed, immersed in the same fixative overnight at 4°C, and then decalcified for four days in 10% ethylenediaminetetra-acetic acid (Wako Chemical, Tokyo, Japan). After storage in 0.01 M phosphate-buffered saline (PBS) containing 20% sucrose for 24 hours at 4°C, the samples were serially sectioned at 40 m in a sagittal plane on a cryostat, and the sections placed on slide glasses.Endogenous tissue peroxidase activity was...

show abstract

“…Facet block represents a selective block of nerve endings in the richly innervated joint capsule [25][26][27]. These pain sensing (nociceptive) nerve endings connect with sensory fibers, which join the medial branch of the dorsal primary ramus.…”

Section: Discussionmentioning

confidence: 99%

Alternative denervation using laser irradiation in lumbar facet syndrome

2007

View full text Add to dashboard Cite

show abstract

Morphological basis for back pain: The demonstration of nerve fibers and neuropeptides in the lumbar facet joint capsule but not in ligamentum flavum

Cited by 153 publications

References 39 publications

Neurokinin 1‐receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus Studies on tennis elbow and medial epicondylalgia

Neurokinin 1‐receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus Studies on tennis elbow and medial epicondylalgia

Sensory nerve fibres from lumbar intervertebral discs pass through rami communicantes

Alternative denervation using laser irradiation in lumbar facet syndrome

Contact Info

Product

Resources

About