Increased pain and sensory hyperinnervation of the ligamentum flavum in patients with lumbar spinal stenosis
Increased pain and sensory hyperinnervation of the ligamentum flavum in patients with lumbar spinal stenosis
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DOI：
10.1002/jor.24251
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发表时间：
2019-03-01
影响因子：
2.8
通讯作者：
Straub, Rainer H.
中科院分区：
文献类型：
--
作者：
Benditz, Achim;Sprenger, Svenja;Straub, Rainer H.
尚未在 LSS 患者的黄韧带 (LF) 中研究伤害性感觉神经纤维。目的是分析 LSS 患者黄韧带 (LF) 中的伤害性感觉神经纤维。对腰椎管狭窄症 (LSS) 患者进行了一项前瞻性研究，他们接受了腰椎管狭窄症 (LSS) 黄切除术的侵入性手术治疗。 LSS 患者接受黄体切除术，并通过免疫染色技术研究感觉神经和交感神经纤维、巨噬细胞、血管、活化成纤维细胞和细胞的密度。一组急性椎间盘突出症患者作为对照组。我们发现 LSS 患者的感觉神经纤维密度高于对照组。这些发现支持 LF 在相关腰痛中的作用。 LSS 中感觉神经纤维的密度与临床疼痛和功能障碍的典型标志物呈正相关，但与活化成纤维细胞的 LF 密度无关。通过巨噬细胞浸润和较高的血管分布估计的炎症在 LSS 患者的 LF 中并未发挥显着作用。在本研究中，与患有 LSS 的男性相比，患有 LSS 的女性表现出更多的疼痛和抑郁，并且 LF 中的感觉神经纤维密度更高。这项研究为伤害感受神经纤维提供了新的线索，与对照组相比，LSS 中伤害感受神经纤维有所增加。这些发现反对 LSS 中存在强烈的炎症成分。与男性相比，女性的疼痛程度更高，可以用伤害性神经纤维密度更高来解释。 (c) 2019 年骨科研究学会。由 Wiley periodicals, Inc. 出版。J Orthop Res 9999:1-7, 2019。
Nociceptive sensory nerve fibers have never been investigated in the ligamentum flavum (LF) of patients with LSS. The aim was to analyze nociceptive sensory nerve fibers in the ligamentum flavum (LF) of patients with LSS. A prospective study in patients with lumbar spinal stenosis (LSS) undergoing invasive surgical treatment for lumbar spinal stenosis (LSS) with flavectomy was performed. Patients with LSS were subjected to flavectomy and density of sensory and sympathetic nerve fibers, macrophages, vessels, activated fibroblasts, and cells were investigated by immunostaining techniques. A group of patients with acute disc herniation served as control group. We found a higher density of sensory nerve fibers in LSS patients versus controls. These findings support the role of LF in associated low back pain. Density of sensory nerve fibers in LSS, was positively correlated with typical markers of clinical pain and functional disability, but not with LF density of activated fibroblasts. Inflammation as estimated by macrophage infiltration and higher vascularity does not play a marked role in LF in our LSS patients. In the present study, compared to men with LSS, women with LSS demonstrate more pain and depression, and show a higher density of sensory nerve fibers in LF. This study shed new light on nociceptive nerve fibers, which are increased in LSS compared to controls. The findings speak against a strong inflammatory component in LSS. A higher pain levels in women compared to men can be explained by a higher density of nociceptive nerve fibers. (c) 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-7, 2019.