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Hauck, Erik F.; Schwefer, Markus; Wittkowski, Werner; Bothe, Hans W.

Measurements and mapping of 282,420 nerve fibers in the S1–5 nerve roots : Laboratory investigation

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  • Media type: E-Article
  • Title: Measurements and mapping of 282,420 nerve fibers in the S1–5 nerve roots : Laboratory investigation : Laboratory investigation
  • Contributor: Hauck, Erik F.; Schwefer, Markus; Wittkowski, Werner; Bothe, Hans W.
  • imprint: Journal of Neurosurgery Publishing Group (JNSPG), 2009
  • Published in: Journal of Neurosurgery: Spine
  • Language: Not determined
  • DOI: 10.3171/2009.3.spine17684
  • ISSN: 1547-5654
  • Origination:
  • Footnote:
  • Description: <jats:sec> <jats:title>Object</jats:title> <jats:p>The study aims to analyze nerve fiber types in the sacral nerve roots as a prerequisite for stimulation.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>One-micrometer cross-sections of human ventral and dorsal S1–5 roots were stained with osmium and toluidine blue. The total fiber diameter and myelin sheath were measured in 282,420 nerve fibers.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The analysis revealed the following 3 main nerve fiber types: Aα fibers (diameter 6–14 μm), Aγ fibers (diameter 2–4 μm), and B fibers (diameter &lt; 2 μm). The B fibers were absent in S-1, present in some S-2 fascicles, and abundant from S-3 to S-5. The Aα fibers dominated the S-1 roots and most fascicles of S-2 roots. In the S3–5 roots, only a few Aα fibers were present. The relative occurrence of Aγ fibers increased from S-1 to S-5. In dorsal roots, Aγ fibers represented ~ 70% of all nerve fibers in every root and fascicle.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The B fibers represented efferent parasympathetic fibers. These fibers were concentrated in certain areas of the nerve roots, not randomly distributed. The Aα fibers innervate lower-extremity muscles and sphincters. The inverse correlation of Aα and Aγ fibers in the ventral roots from S-1 to S-5 is surprising. In dorsal roots, Aγ fibers may conduct pain, touch, and temperature signals. Highly selective fiber stimulation specific for type, location, and direction may improve sacral nerve stimulation for a spastic bladder in paraplegic individuals.</jats:p></jats:sec>