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Related Concept Videos

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Spinal Nerves: Plexus II

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Vertebral body innervation: Implications for pain.

Michelangelo Buonocore1, Anna Maria Aloisi, Massimo Barbieri

  • 1Unit of Clinical Neurophysiology & Neurodiagnostic Skin Biopsy, Fondazione Maugeri, Via Maugeri 10, 27100 Pavia, Italy. michelangelo.buonocore@fsm.it

Journal of Cellular Physiology
|December 19, 2009
PubMed
Summary

Vertebral body innervation is scarce, with most nerve fibers located around blood vessels. This limited nerve distribution suggests it

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Area of Science:

  • Neuroscience
  • Orthopedic Surgery
  • Pain Research

Background:

  • Vertebral fractures frequently result in severe, persistent pain.
  • The role of vertebral body innervation in pain perception and relief following procedures like kyphoplasty remains unclear.

Purpose of the Study:

  • To investigate the innervation patterns within human vertebral bodies.
  • To determine the relationship between nerve fibers and blood vessels in the vertebral bodies.
  • To assess the potential contribution of vertebral innervation to pain experienced with fractures and pain relief after kyphoplasty.

Main Methods:

  • Collection of vertebral body specimens from 31 patients undergoing percutaneous kyphoplasty.
  • Histological analysis of 1,876 preparations.
  • Immunohistochemical staining using Protein Gene Product 9.5 (PGP 9.5) for nerve fibers and type IV collagen (Col IV) for vessels.

Main Results:

  • Nerve fibers were identified in 35% of male and 29% of female specimens.
  • Innervation percentages varied by spinal level and sex.
  • Approximately 95% of identified nerve fibers were found in close proximity to blood vessels.

Conclusions:

  • Vertebral bodies exhibit limited innervation, predominantly associated with vascular structures.
  • The observed pattern of scarce vertebral body innervation is unlikely to be the primary driver of vertebral pain or pain reduction after kyphoplasty.