Aim: 

Vertebral fractures often cause intractable pain and a useful relief procedure is reconstruction of the vertebral body through percutaneous kyphoplasty. To define the involvement of vertebral body innervation in pain treatment with kyphoplasty, we collected specimens from male and female patients during kyphoplasty for vertebral fractures.

Methods: 

Immunohistochemical techniques were used to locate the nerves in the specimens. The nerve fibres were labelled by indirect immunofluorescence with the primary antibody directed against PGP 9.5, a pan-neuronal marker; moreover, another primary antibody directed against type IV collagen was used to determine their relationship with vertebral vessels.

Results: 

Specimens were taken from 31 patients (9 men and 22 women) suffering high intensity pain before surgery. In total, 1876 histological preparations were obtained and analysed. The mean proportion of samples in which it was possible to identify nerve fibres was 35% in men and 29% in women. The percentages varied depending on the spinal level considered and the sex of the subject, nerve fibres being mostly present around vessels (95%).

Conclusion: 

Due to the paucity of nerve fibres and their presence around vessels, it is unlikely that vertebral body innervation is involved in pain or is important in pain relief by kyphoplasty.