Involvement of the sinuvertebral nerve in the treatment of chronic low back pain through dorsal root ganglion neurostimulation: an anatomical study.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2025-06-13 DOI:10.1007/s00276-025-03671-3

Stéphanie Ravaillault, Edouard Samarut, Stéphane Ploteau, Antoine Hamel, Cyrille Decante, Alexis Moles, Céline Salaud

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Abstract

Objective: Due to the anatomical proximity of the SVN to the dorsal root ganglion (DRG), several authors have highlighted the potential benefits of DRG stimulation in the management of chronic low back pain. However, the optimal vertebral level for electrode implantation remains debated. To determine the relevance of stimulating the sinuvertebral nerve (SVN) in the management of chronic low back pain and the most appropriate vertebral level for the implantation of this type of electrode.

Methods: We dissected the thoraco-lumbar spine (T12 to L5) of six anatomical specimens to highlight the path, innervation areas, and various branches of the SVN.

Results: We confirmed that the SVN innervates the posterior third of the intervertebral discs (IVD), the posterior longitudinal ligament (PLL), the anterior face of the dural sheath, the periosteum, the walls of the basivertebral veins, the segmental arteries, and their branches. Moreover, we demonstrated the dual somatic and sympathetic roles of the SVN. Finally, we observed an intra- and intersegmental network covering several adjacent vertebral levels. The superficial network of the SVN converges towards the L2 spinal nerve (SN).

Conclusion: We demonstrated the anatomical rationale for stimulating the DRG through rigorous anatomical dissection of the SVN. The most relevant indication appears to be for Persistant Spinal Pain Syndrome (PSPS) type 2 patients, with electrode implantation at the L2 vertebral level bilaterally.

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经背根神经节神经刺激治疗慢性腰痛涉及椎神经的解剖学研究。

目的：由于SVN在解剖学上接近背根神经节（DRG），一些作者强调了刺激DRG治疗慢性腰痛的潜在益处。然而，电极植入的最佳椎体水平仍然存在争议。目的探讨刺激椎弓根神经（SVN）在治疗慢性腰痛中的相关性，以及该类型电极植入的最合适椎体水平。方法：对6例胸腰椎（T12 ~ L5）解剖标本进行解剖，突出显示SVN的路径、神经支配区域和各种分支。结果：我们证实SVN神经支配椎间盘后三分之一、后纵韧带、硬膜鞘前面、骨膜、椎基静脉壁、节段动脉及其分支。此外，我们证明了SVN的双重躯体和交感作用。最后，我们观察到覆盖几个相邻椎体水平的节段内和节段间网络。SVN的浅表神经网络向L2脊神经（SN）收敛。结论：我们通过对SVN进行严格的解剖解剖，证明了刺激DRG的解剖学原理。最相关的适应症似乎是持续脊柱疼痛综合征（PSPS） 2型患者，电极植入在双侧L2椎体水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.