Sunday, June 1, 2008

Pathologies of TLF (Thoracolumbar Fascia) and mechanisms of it’s pain genesis:

Many investigators have defined the presence of innervation in control (no back pain) tissue specimens.
In a study to define the innervation of the thoracolumbar fascia (in problem back pain patients who have articular abnormality defined through pain-provocation discography or facet blocks) found that the thoracolumbar fascia may be deficiently innervated in problem back pain patients. In this study sample collected from operating room (form lumbar spinal surgery patients) and later processed and studied under light and electron microscopy failed to identify specific neural end-organs in any of the specimens. Rather these samples show microscopic changes suggestive of ischemia or inflammation in this tissue were found.
But recent finding suggest otherwise. In addition to free nerve endings, two types of encapsulated mechanoreceptors (Ruffini's and Vater-Pacini corpuscles) were identified. These findings support the hypothesis that the thoracolumbar fascia may play a neurosensory role in the lumbar spine mechanism.

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