An anatomic study of neuropeptide immunoreactivities in the lumbar dura mater after lumbar sympathectomy.
METHODS
The distribution and density of nerve innervation in the lumbar dura mater after lumbar sympathectomy were assessed in wistar rats.


OBJECTIVE
To provide basic information on the interaction between sympathetic and sensory nerves in patients with low back pain.


BACKGROUND
Many studies have indicated that the sinuvertebral nerve has an important role in innervating the tissues around the vertebrae. However, the origin, innervating pattern, and connections between the nerves are still controversial. It is well known that pain is often accompanied with sympathetic symptoms and exaggerated by sympathetic stimuli. Occasionally, anesthetic block at the L2 or L3 sympathetic ganglion relieves low back pain or symptoms associated with low back pain. The authors assessed the changes of the density and distribution of nerve innervation of the lumbar dura mater after lumbar sympathectomy.


METHODS
Normal adult rats were sympathectomized at L2-L3. The threshold for thermal noxious pain by hot-plate analgesia test and changes in neuropeptides in the lumbar dura mater and dorsal root ganglia using light microscopic immunohistochemistry were assessed and compared with control rats.


RESULTS
In the hot-plate analgesia test, sympathectomized rats increased their hot-plate latency time compared with that of sham-operated rats. Density of calcitonin gene-related peptide immunoreactive fibers in sympathectomy side of the lumbar dura mater decreased to 45.5% compared with the contralateral side. The number and size of calcitonin gene-related peptide immunoreactive cells in dorsal root ganglia showed no difference between sympathectomized and contralateral side.


CONCLUSIONS
Sympathectomy increased the pain threshold and made the sympathectomized rats hypesthetic. A large numbers of sensory fibers innervated the lumbar dura mater via L2-L3 sympathetic nerve in rats. Sympathectomy reduced the number of these nerve fibers in the lumbar dura mater. Sympathetic nerves may play an important role for low back pain involving the lumbar dura mater.
Sekiguchi
Y
Y
Department of Orthopaedic Surgery, Fukushima Medical College, Japan.
Konnai
Y
Y
Kikuchi
S
S
Sugiura
Y
Y
D000818:Animals; D015740:Calcitonin Gene-Related Peptide / Q000032:analysis; D004388:Dura Mater / Q000033:anatomy & histology* / Q000737:chemistry; D005260:Female; D005727:Ganglia, Spinal / Q000737:chemistry; D017116:Low Back Pain / Q000209:etiology; D008161:Lumbosacral Region; D009412:Nerve Fibers / Q000737:chemistry; D009479:Neuropeptides / Q000032:analysis*; D017288:Pain Threshold; D051381:Rats; D017208:Rats, Wistar; D013562:Sympathectomy; D013564:Sympathetic Nervous System / Q000033:anatomy & histology* / Q000502:physiology
D009479:Neuropeptides; D015740:Calcitonin Gene-Related Peptide