Molecular evidence for local denervation of paraspinal muscles in failed-back surgery/postdiscotomy syndrome

Clin Neuropathol. 2003 Mar-Apr;22(2):71-7.


A study was performed to analyze whether local denervation of the medial branch of the dorsal ramus of the lumbar spinal nerve occurs in a patient with postoperative failed-back surgery syndrome/postdiscotomy syndrome (FBSS/PDS). We investigated the effect of the loss of innervation of the multifidus muscle on neuronal nitrite oxide synthetase (n-NOS) and endothelial nitrite oxide synthetase (e-NOS) applying realtime RT-PCR and immunohistochemistry. Our study demonstrates a substantial reduction of n-NOS expression, supporting the view that local denervation of the multifidus is involved in the pathology of FBSS. No regulation of e-NOS was detectable. Interestingly, this change is region-specific and does not occur throughout the entire multifidus segment. This result supports the hypothesis that local denervation of the multifidus muscle is involved in the pathology of FBSS/ PDS.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biopsy
  • Down-Regulation
  • Humans
  • Intervertebral Disc Displacement / surgery
  • Laminectomy / adverse effects*
  • Low Back Pain / etiology*
  • Lumbar Vertebrae / surgery
  • Male
  • Muscle, Skeletal / innervation*
  • Muscle, Skeletal / metabolism
  • Muscle, Skeletal / pathology
  • Muscular Atrophy, Spinal / etiology*
  • Muscular Atrophy, Spinal / pathology
  • Neurons / enzymology
  • Nitric Oxide Synthase / metabolism
  • Peripheral Nerve Injuries
  • Syndrome


  • Nitric Oxide Synthase