title: Observations on the pathomorphology of the thoracolumbar fascia in chronic mechanical back pain. A microscopic study.
abstract: METHODS
  Human tissue specimens were examined for the presence of neural end-organs under light and electron microscopy.
  
  
  OBJECTIVE
  To define the innervation of the thoracolumbar fascia in problem back pain patients who have articular abnormality defined through pain-provocation discography or facet blocks.
  
  
  BACKGROUND
  Previous investigators have defined the presence of innervation in control (no back pain) tissue specimens.
  
  
  METHODS
  Tissue specimens were harvested during surgery from 24 back pain patients who had not undergone previous lumbar surgery. Specimens were fixed immediately in the operating room and later processed and studied under light and electron microscopy.
  
  
  RESULTS
  Structural and ultrastructural studies failed to identify specific neural end-organs in any of the specimens. Serendipidously, microscopic changes suggestive of ischemia or inflammation in this tissue were found.
  
  
  CONCLUSIONS
  These findings suggest that the thoracolumbar fascia may be deficiently innervated in problem back pain patients.
authors.affiliation: Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: D A
authors.initials: DA
authors.lastname: Bednar
authors.forename: F W
authors.initials: FW
authors.lastname: Orr
authors.forename: G T
authors.initials: GT
authors.lastname: Simon
mesh_terms: D001416:Back Pain / Q000473:pathology*; D001485:Basement Membrane / Q000648:ultrastructure; D002114:Calcinosis; D003094:Collagen / Q000648:ultrastructure; D004848:Epithelium / Q000648:ultrastructure; D005205:Fascia / Q000098:blood supply / Q000294:innervation* / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007511:Ischemia / Q000473:pathology; D008159:Lumbar Vertebrae; D008297:Male; D009411:Nerve Endings / Q000648:ultrastructure; D013904:Thoracic Vertebrae
chemical_list: D003094:Collagen