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Sinuvertebral Nerve

nervus sinuvertebralis Luschkae

The sinuvertebral nerve (recurrent meningeal nerve, nerve of Luschka) is a small mixed nerve formed at each spinal level by a somatic branch from the spinal nerve and an autonomic branch from the grey ramus communicans. It re-enters the intervertebral foramen to supply the posterior longitudinal ligament, the posterior annulus fibrosus, the anterior dura, the epidural vessels, and the periosteum of the posterior vertebral body.

Region: Lower Back

Clinical Relevance

Clinical Notes

The sinuvertebral nerve is the principal pain nerve of the intervertebral disc and posterior longitudinal ligament, transmitting discogenic and posterior ligamentous pain. Annular fissures that reach the outer annular fibres where the sinuvertebral nerve terminals are located produce discogenic low back pain without nerve root compression. Epidural steroid injections achieve their anti-inflammatory effect in part by reducing sensitisation of sinuvertebral nerve terminals. Disc degeneration with PLL irritation produces axial back pain mediated by this nerve independent of radicular involvement.

Pathology

Common Injuries & Conditions

Sinuvertebral Nerve Sensitisation in Discogenic Pain

Annular fissures reaching the outer annulus stimulate sinuvertebral nerve terminals producing discogenic low back pain without radiculopathy, reproduced by provocative discography; epidural corticosteroid injection around the PLL and outer annulus reduces sinuvertebral nerve inflammation, providing temporary relief pending definitive management.