The intrinsic nerve supply of the human lumbar spine. A light- and electronmicroscopic and immunohistochemical study

Abstract

The present manuscript attempts to provide a comprehensive description of the microscopical anatomy and the innervation of the lumbar spine, based on Bogduk's classification. Particular attention is given to origin, terminal arborisation and neuropeptides of the intrinsic nerves of the human lumbar spine using light- and electron microscopy and immunocytochemistry. An important statement of Bogduk (1983), "Whatever it is in the lumbar spine that causes pain, it must have a nerve supply", will always hold true. Only the deep structures of the lumbar spine, pertinent to the discussion of the anatomical basis of low back pain, are included in the present manuscript, meaning: the meningeal structures, intervertebral disc, facet joints, ligaments, vessels, meningeal structures, the vertebral bodies, and muscles. Hypothetical mechanisms of pain originating in the lumbar spine, are briefly discussed. In this study we also documented the fine structural characteristics of human spinal dura mater and arachnoid mater, with special reference to their spatial relationships.