• Spine · Jan 2020

    The Anatomical Study and Clinical Significance of the Sinuvertebral Nerves at the Lumbar Levels.

    • Qinghao Zhao, Liang Cheng, Huibo Yan, Shangxi Deng, Jianjun Zhao, Zezheng Liu, Xuemei Tan, Enyi Zhong, Wentao Zhuo, Dadi Jin, and Qingchu Li.
    • Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
    • Spine. 2020 Jan 15; 45 (2): E61-E66.

    Study DesignA dissection-based study of 10 embalmed human cadavers.ObjectiveThe purpose of this study was to describe the sinuvertebral nerves at the lumbar level and to discuss their possible clinical significance.Summary Of Background DataDiscogenic low-back pain is mediated by the sinuvertebral nerves. However, the detailed descriptions of the sinuvertebral nerves at the lumbar level are lacking.MethodsOne hundred L1-L5 intervertebral foramina from 10 embalmed cadavers were studied. The presence of the sinuvertebral nerves was noted. The quantity, origin, pathway, innervation range, and spatial orientations of the sinuvertebral nerves in the L1-L5 intervertebral foramina were examined.ResultsA total of 450 sinuvertebral nerves were identified in the 100 lumbar intervertebral foramina; sinuvertebral nerves were observed in 100.00% of the intervertebral foramina. The sinuvertebral nerves were routinely divided into the following two types: the sinuvertebral nerve deputy branch and sinuvertebral nerve main trunk. Three hundred twelve sinuvertebral nerve deputy branches were found; on average, there were approximately 3.12 (range, 1-8) branches in each intervertebral foramen. One hundred thirty-eight sinuvertebral nerve main trunks were found, and sinuvertebral nerve main trunks were observed in 97.00% of the intervertebral foramina. The initial portion of the sinuvertebral nerve was located along the posterior-lateral edge of the disc to the spinal canal. Sixty-one (44.20%) sinuvertebral nerve main trunks originated from the starting point of the gray ramus communicans of the nerve root; 77 (55.80%) sinuvertebral nerve main trunks originated from the anterior surface of the spinal ganglia of the nerve root.ConclusionThis is a systematic anatomy study that describes the sinuvertebral nerve at the lumbar level and may be of clinical importance to spinal surgeons. A comprehensive understanding of the distribution of sinuvertebral nerves may lead to significant benefits for patients undergoing percutaneous endoscopic treatment for discogenic low-back pain.Level Of Evidence4.

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