open access

Vol 82, No 1 (2023)
Original article
Submitted: 2021-12-20
Accepted: 2022-01-05
Published online: 2022-01-31
Get Citation

Are the nerves supplying the anterior sacroiliac joint nociceptive?

E. Yilmaz1, A. V. D’Antoni2, Ł. Olewnik3, J. Iwanaga456, T. Saga7, M. Loukas8, R. S. Tubbs45891011
·
Pubmed: 35112339
·
Folia Morphol 2023;82(1):96-101.
Affiliations
  1. Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz, Bochum, Germany
  2. Wagner College, Staten Island, New York and Division of Anatomy, Department of Radiology, Weill Cornell Medicine, New York, NY, United States
  3. Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
  4. Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, United States
  5. Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, United States
  6. Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  7. Domain of Anatomy, Kurume University School of Nursing, Kurume, Fukuoka, Japan
  8. Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada, West Indies
  9. Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, United States
  10. Department of Surgery, Tulane University School of Medicine, New Orleans, LA, United States
  11. Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, United States

open access

Vol 82, No 1 (2023)
ORIGINAL ARTICLES
Submitted: 2021-12-20
Accepted: 2022-01-05
Published online: 2022-01-31

Abstract

Background: Sacroiliac joint (SIJ) pain is often difficult to diagnose. Moreover, while its anatomical characteristics have been well studied, its innervation and the contributions of particular nerves remain controversial, especially in relation to posterior joint innervation. To our knowledge, previous studies have not investigated the presence of nociceptive fibres in the nerves innervating the anterior SIJ.
Materials and methods: Eight adult cadaveric sides underwent dissection of the anterior SIJ. Adjacent anterior rami were examined for branches to the anterior SIJ. Any branches contributing to the anterior SIJ were measured and then resected. These samples were fixed in formalin and substance P was identified immunohistologically.
Results: On all sides, 1–2 small branches (mean diameter of 0.33 mm) arose from the posterior aspect of the L4 anterior ramus (12.5%), the L5 anterior ramus (62.5%), or simultaneously from both the L4 and L5 anterior rami (25%). These branches had a mean length of 13.5 mm. All histological samples contained nerve tissue. All samples of nerve fibres traveling to the anterior SIJ were positive for diffuse substance P reactivity. There were no histological differences between sides or sex. Each of the branches identified as travelling to the SIJ exhibited similar positivity for substance P.
Conclusions: This cadaveric study demonstrates that the anterior SIJ nerve fibres carry pain fibres. This new knowledge has application to patients with SIJ syndrome and to its various treatments including interventional approaches to SIJ pain.

Abstract

Background: Sacroiliac joint (SIJ) pain is often difficult to diagnose. Moreover, while its anatomical characteristics have been well studied, its innervation and the contributions of particular nerves remain controversial, especially in relation to posterior joint innervation. To our knowledge, previous studies have not investigated the presence of nociceptive fibres in the nerves innervating the anterior SIJ.
Materials and methods: Eight adult cadaveric sides underwent dissection of the anterior SIJ. Adjacent anterior rami were examined for branches to the anterior SIJ. Any branches contributing to the anterior SIJ were measured and then resected. These samples were fixed in formalin and substance P was identified immunohistologically.
Results: On all sides, 1–2 small branches (mean diameter of 0.33 mm) arose from the posterior aspect of the L4 anterior ramus (12.5%), the L5 anterior ramus (62.5%), or simultaneously from both the L4 and L5 anterior rami (25%). These branches had a mean length of 13.5 mm. All histological samples contained nerve tissue. All samples of nerve fibres traveling to the anterior SIJ were positive for diffuse substance P reactivity. There were no histological differences between sides or sex. Each of the branches identified as travelling to the SIJ exhibited similar positivity for substance P.
Conclusions: This cadaveric study demonstrates that the anterior SIJ nerve fibres carry pain fibres. This new knowledge has application to patients with SIJ syndrome and to its various treatments including interventional approaches to SIJ pain.

Get Citation

Keywords

back pain, sacroiliac joint pain, syndrome, innervation

About this article
Title

Are the nerves supplying the anterior sacroiliac joint nociceptive?

Journal

Folia Morphologica

Issue

Vol 82, No 1 (2023)

Article type

Original article

Pages

96-101

Published online

2022-01-31

Page views

3444

Article views/downloads

1425

DOI

10.5603/FM.a2022.0009

Pubmed

35112339

Bibliographic record

Folia Morphol 2023;82(1):96-101.

Keywords

back pain
sacroiliac joint pain
syndrome
innervation

Authors

E. Yilmaz
A. V. D’Antoni
Ł. Olewnik
J. Iwanaga
T. Saga
M. Loukas
R. S. Tubbs

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