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Abstract Background and Rationale chronic discogenic low back pain is a major problem in many industrializednations.The innervation and transmission of nociceptive informationfrom painful lumbar discs has only recently been better described. Internal disc disruption (IDD) is thought to account for 40% of cases ofchronic low back pain (1). The mechanism of pain from IDDand its transmission is not completelyelucidated. It is well accepted that theouter one-third of the annulus fibrosis receives rich sensory innervation. Abnormal nerve in-growth and sensitization ofnociceptors in the annulus fibrosis havebeen thought to distinguish a painful IDD from a painless one (2).How this nociceptiveinformation is transmitted intothe central nervous system in humans isnot clear. In the rat, sensory informationfrom the lumbar intervertebral discs istransmitted from the sinuvertebral nerveinto the rami communicans on each sideof a given disc.The rami communicansthen preferably connect to the paravertebralsympathetic chain (3) |