Lumbar disc

The intervertebral disc (IVD) is a joint unique in structure and functions. Lying between adjacent vertebrae provides both the primary support and the elasticity required for the spine to move stably. Various aspects of IVD have long been studied by researchers seeking a better understanding of its dynamics, aging, and subsequent disorders. In a paper, Ghannam et al., review the surgical anatomy, imaging modalities, and molecular biology of the lumbar IVD 1).

Studies have shown that lumbar discs do not always narrow with age, implying that a process other than aging is in work 2)

Physicians need standard terms for normal and pathological conditions of lumbar discs 3) 4) 5) 6).

The lumbar intervertebral discs are supplied by a variety of nerves. The posterior aspects of the discs and the posterior longitudinal ligament are innervated by the sinuvertebral nerves. The posterolateral aspects of the discs receive branches from adjacent ventral primary rami and from the grey rami communicantes near their junction with the ventral primary rami. The lateral aspects of the discs receive other branches from the rami communicantes. Some rami communicantes cross intervertebral discs and are embedded in the connective tissue of the disc deep to the origin of psoas. Such paradiscal rami are likely to be another source of innervation to the discs. The anterior longitudinal ligament is innervated by recurrent branches of rami communicantes 7).

Ghannam M, Jumah F, Mansour S, Samara A, Alkhdour S, Alzuabi MA, Aker L, Adeeb N, Massengale J, Oskouian R, Tubbs RS. Surgical anatomy, radiological features, and molecular biology of the lumbar intervertebral discs. Clin Anat. 2016 Dec 20. doi: 10.1002/ca.22822. [Epub ahead of print] Review. PubMed PMID: 27997062.
Miller JA, Schmatz C, Schultz AB. Lumbar disc degeneration: Correlation with age, sex, and spine level in 600 autopsy specimens. Spine (Phila Pa 1976) 1988;13:173–8.
Stadnik TW, Lee RR, Coen HL, et al. Annular tear and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciatica. Radiology 1998;206:49–55.
Mink JH. Terminology of Lumbar Spine Disorders, the Problem … and a Solution. Burlingame, CA: California Managed Imaging Medical Group Publication; 1993:1–4.
Murtagh FR. The importance of being earnest—about disk nomenclature. AJNR Am J Neuroradiol 2007;28:1–2.
Nordby EJ, Brown MD, Dawson ED, et al., eds. A Glossary on Spinal Terminology. Chicago, IL: American Academy of Orthopaedic Surgeons; 1985:31–2.
Bogduk N, Tynan W, Wilson AS. The nerve supply to the human lumbar intervertebral discs. J Anat. 1981 Jan;132(Pt 1):39-56. PubMed PMID: 7275791; PubMed Central PMCID: PMC1233394.
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