Clinical anatomy of the lumbar sinuvertebral nerve with regard to discogenic low back pain and review of literature Article

Full Text via DOI: 10.1007/s00586-021-06886-1 Web of Science: 000656082800001
International Collaboration

Cited authors

  • Quinones S, Konschake M, Aguilar LL, Simon C, Aragones P, Hernandez LM, Abramovic A, Tubbs SR, Bouzad J, Valderrama-Canales FJ, Vazquez T, Sanudo J

Abstract

  • Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43, 72.1%), common branch diverging into two branches (10/43, 23.3%), double ascending branch (1/43, 2.3%) finalizing two levels above and a descending branch (1/43, 2.3%). In 12/43 cases (27.9%) the SVN had ipsilateral connections with another SVN. The distribution ended in the middle of the vertebral body supplying adjacent structures. Conclusion A thorough understanding of the anatomy of the SVN might lead to significant benefits in therapy of discogenic low back pain. We suggest blocking the SVN at the level of the inferior vertebral notch of two adjacent segments.

Publication date

  • 2021

Published in

International Standard Serial Number (ISSN)

  • 0940-6719

Number of pages

  • 10