Effect of the L2 ramus communicans on the nociceptive pathway in lumbar intervertebral discs in rats

The mechanism underlying discogenic low-back pain is unclear. It is difficult to explain this type of pain by the segmental innervation theory because the groin area is innervated by the genitofemoral or ilioinguinal nerves, which are the terminal branches of the L1 or L2 spinal nerves. Recently, some studies have indicated that sympathetic trunks are closely related to discogenic low-back pain. However, sympathetic trunk resection can severely affect the function of the abdominal organs and lower extremities and may cause retrograde ejaculation in human beings. This study was initiated to evaluate the role of selective transection of the L2 ramus of the nociceptive pathway in the lumbar intervertebral discs in rats, by using the fluorogold (FG) retrograde transport method and immunohistochemistry of substance P (SP). Of the FG-labeled neurons in the L2 and L5 dorsal root ganglia (DRGs), the cross-sectional area of the SP-immunoreactive (ir) neurons ranged from 210 to 1140 μm2; the mean cross-sectional area was 652 ± 320 μm2. We demonstrated that FG-labeled SP-ir neurons in L2 DRGs decreased when FG was applied to the ventral or dorsal portions of L5-6 discs. The results indicated that the L2 ramus communicans played an important role in the afferent pathway of both the ventral and dorsal portions of the L5-6 disc. Nociceptive information from the L5-6 disc may be transmitted mainly by L2 DRG neurons through the L2 ramus communicans.