Sinuvertebral Nerve

Original Editor - Denys Nahornyi

Top Contributors - Denys Nahornyi

Description

Sinuvertebral nerve (arrows) taking a recurrent course and reenters the spinal canal through the intervertebral foramen.

The sinuvertebral nerve (or Luschka nerve) is a recurrent nerve that originates from the ventral ramus rande-entering the spinal canal via the intervertebral foramina to innervate the anulus fibrosus of the intervertebral disc, the ligaments and periosteum of the spinal canal. Its complex anatomy and relationship to discogenic pain have warranted great interest among clinical anatomists owing to its sympathetic contribution to the lumbar spine. Knowledge of the nerve has been used to design a variety of diagnostic and treatment procedures for chronic discogenic pain [1].

Root

Spinal nerve.

Branches

Sinuvertebral nerve originates from the ventral ramus of spinal nerves.

Function

Innervate multiple meningeal and non-meningeal structures. Is a somatic and vegetative nerve.

Motor

Absent.

Sensory

Clinical relevance

The synvertebral nerve (red arrows) may grow deep into the disc

Associated with the discogenic type low back pain (pain from an injured vertebral disc), accounts for approximately 26%–39% of patients with low back pain [2].

Although the sinuvertebral nerve fibers are said to terminate in the outer anulus, it is now widely accepted that this end point is not permanent. Studies of healthy patients normally show neural penetration of the anulus at about 3 mm [3], corresponding to the three outer lamellae. However, degenerative discs have shown penetration of nerve fibers as far as the inner one third in one study [4], and into the nucleus pulposus in another [5].

Assessment

Provocative discography (has proved significantly more effective for diagnosing degenerative disc disease than magnetic resonance imaging) [6].

See also

References

  1. Shayota B, Wong TL, Fru D, David G, Iwanaga G, Loukas M. A comprehensive review of the sinuvertebral nerve with clinical applicationsAnat Cell Biol. 2019;52(2):128-133.
  2. Manchikanti L, Singh V, Pampati V, Damron KS, Barnhill RC, Beyer C, Cash KA. Evaluation of the relative contributions of various structures in chronic low back pain. Pain Physician. 2001;4:308–316.
  3. Ashton IK, Walsh DA, Polak JM, Eisenstein SM. Substance P in intervertebral discs: binding sites on vascular endothelium of the human annulus fibrosus. Acta Orthop Scand. 1994;65:635–639.
  4. McCarthy PW, Carruthers B, Martin D, Petts P, Films DC. Immunohistochemical Demonstration of Sensory Nerve Fibers and Endings in Lumbar Intervertebral Discs of the Rat. Spine.1991;16:653-655.
  5. Peng B, Wu W, Hou S, Li P, Zhang C, Yang Y. The pathogenesis of discogenic low back painJ Bone Joint Surg Br. 2005;87(1):62-67.
  6. Choi SH, Adsul N, Kim HS, Jang JS, Jang IT, Oh SH. Magnetic resonance imaging undetectable epiduroscopic hotspot in chronic diskogenic back pain: does sinuvertebral neuropathy actually exist? World Neurosurg. 2018;110:354–358