Ohtori S, Takahashi Y, Takahashi K, Yamagata M, Chiba T, Tanaka K, Hirayama J, Moriya H
Department of Orthopaedic Surgery, School of Medicine, Chiba University, Japan.
Spine (Phila Pa 1976). 1999 Nov 15;24(22):2295-9. doi: 10.1097/00007632-199911150-00002.
The vertebral levels of dorsal root ganglia innervating the dorsal portion of the L5-L6 intervertebral disc were investigated in rats using a retrograde transport method. The pathways and functions of nerve fibers supplying the dorsal portion of the disc were determined by denervation and immunohistochemistry.
The dorsal portion of the lumbar intervertebral disc has been reported to be innervated segmentally, but anesthetic block of the paravertebral sympathetic trunks and the L2 spinal nerve can relieve discogenic low back pain. In the current study, the sensory innervation of the dorsal portion of the L5-L6 intervertebral disc was investigated, because the disc anatomically corresponds to the L4-L5 disc in humans, and the dorsal portion of the human L4-L5 disc is frequently subject to injury that causes low back pain.
A retrograde transport of Fluoro-Gold (F-G; Fluorochrome, Denver, CO) was used. Subjects included nontreated control (n = 32) and sympathectomized rats in which paravertebral sympathetic trunks were removed from L2 to L3 (n = 9). In a ventral approach, Fluoro-Gold crystals were placed on the dorsal portion of the L5-L6 disc, and labeled neurons in the bilateral dorsal root ganglia from T10 to L6 were counted.
Fluoro-Gold crystals did not leak from the dorsal portion of the L5-L6 disc in 14 of the 32 nontreated rats and in 5 of the 9 sympathectomized rats. These rats were used for analysis. Fluro-Gold-labeled neurons were found in dorsal root ganglia from T13 to L6 in the 14 control rats but only from L2 to L6 in the 5 sympathectomized rats.
The dorsal portion of the L5-L6 disc of rats was shown to be multisegmentally innervated by the T13 to L6 dorsal root ganglia. The sensory fibers from T13, L1, and L2 dorsal root ganglia were shown to innervate the dorsal portion of the L5-L6 disc through the paravertebral sympathetic trunks. In contrast, those from the L3-L6 dorsal root ganglia may innervate the dorsal portion of the L5-L6 disc through the sinuvertebral nerves.
采用逆行运输法在大鼠中研究支配L5-L6椎间盘背侧部分的背根神经节的椎体水平。通过去神经支配和免疫组织化学确定供应椎间盘背侧部分的神经纤维的通路和功能。
据报道,腰椎间盘的背侧部分由节段性神经支配,但椎旁交感干和L2脊神经的麻醉阻滞可缓解盘源性下腰痛。在本研究中,对L5-L6椎间盘背侧部分的感觉神经支配进行了研究,因为该椎间盘在解剖学上相当于人类的L4-L5椎间盘,且人类L4-L5椎间盘的背侧部分经常受到导致下腰痛的损伤。
使用荧光金(F-G;Fluorochrome,丹佛,科罗拉多州)进行逆行运输。研究对象包括未处理的对照组(n = 32)和从L2至L3切除椎旁交感干的交感神经切除大鼠(n = 9)。通过腹侧入路,将荧光金晶体置于L5-L6椎间盘的背侧部分,并计数从T10至L6双侧背根神经节中标记的神经元。
在32只未处理大鼠中的14只以及9只交感神经切除大鼠中的5只中,荧光金晶体未从L5-L6椎间盘的背侧部分漏出。这些大鼠用于分析。在14只对照大鼠中,在T13至L6的背根神经节中发现了荧光金标记的神经元,但在5只交感神经切除大鼠中仅在L2至L6发现。
大鼠L5-L6椎间盘的背侧部分显示由T13至L6背根神经节多节段支配。来自T13、L1和L2背根神经节的感觉纤维显示通过椎旁交感干支配L5-L6椎间盘的背侧部分。相比之下,来自L3-L6背根神经节的纤维可能通过窦椎神经支配L5-L6椎间盘的背侧部分。