Innervation of the Human Intervertebral Disc: A Scoping Review.

Annulus Fibrosus Back Pain Intervertebral Disc Degeneration Neuroanatomy Nucleus Pulposus Peripheral Nervous System

Journal

Pain medicine (Malden, Mass.)
ISSN: 1526-4637
Titre abrégé: Pain Med
Pays: England
ID NLM: 100894201

Informations de publication

Date de publication:
04 06 2021
Historique:
pubmed: 18 2 2021
medline: 25 6 2021
entrez: 17 2 2021
Statut: ppublish

Résumé

Back pain is an elusive symptom complicated by a variety of possible causes, precipitating and maintaining factors, and consequences. Notably, the underlying pathology remains unknown in a significant number of cases. Changes to the intervertebral disc (IVD) have been associated with back pain, leading many to postulate that the IVD may be a direct source of pain, typically referred to as discogenic back pain. Yet despite decades of research into the neuroanatomy of the IVD, there is a lack of consensus in the literature as to the distribution and function of neural elements within the tissue. The current scoping review provides a comprehensive systematic overview of studies that document the topography, morphology, and immunoreactivity of neural elements within the IVD in humans. Articles were retrieved from six separate databases in a three-step systematic search and were independently evaluated by two reviewers. Three categories of neural elements were described within the IVD: perivascular nerves, sensory nerves independent of blood vessels, and mechanoreceptors. Nerves were consistently localized within the outer layers of the annulus fibrosus. Neural ingrowth into the inner annulus fibrosus and nucleus pulposus was found to occur only in degenerative and disease states. While the pattern of innervation within the IVD is clear, the specific topographic arrangement and function of neural elements in the context of back pain remains unclear.

Identifiants

pubmed: 33595648
pii: 6141029
doi: 10.1093/pm/pnab070
pmc: PMC8185559
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1281-1304

Subventions

Organisme : CIHR
ID : 115068
Pays : Canada

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Auteurs

Adam M R Groh (AMR)

Integrated Program in Neuroscience, The Montreal Neurological Institute-Hospital, Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada.

Dale E Fournier (DE)

Health and Rehabilitation Sciences (Physical Therapy), Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.

Michele C Battié (MC)

Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.
School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.

Cheryle A Séguin (CA)

Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.
Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.

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Classifications MeSH