Pain generators of the lumbar spine

Pain generators of the lumbar spine
1) sinuvertebral nerve innervation
- ant. vertebral body, external annulus, PLL

2) medial branch of the dorsal primary ramus innervation
- Z-joint, interspinous ligaments, lumbar multifidi

3) other small branch of the dorsal primary ramus innervation
- post. vertebral body, lumbar paraspinal muscles and fascia

4) lumbar sympathetic chain의 branch인 gray rami communicans(GRC) innervation
- ALL

5) internal annulus fibrosus, NP
- not innervation
- non-disease state에서 pain transmit 하지 않음
(신경이 있으면 통증 유발 or 전달이 되지만 innervation 없으면 통증 유발 부위 아님)