Mechanisms of low back pain: a neurophysiologic and neuroanatomic study.
Mechanisms of low back pain: a neurophysiologic and neuroanatomic study.
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DOI：
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发表时间：
1997-02
影响因子：
4.2
通讯作者：
J. Cavanaugh;Ozaktay Ac;T. Yamashita;A. Avramov;T. Getchell;A. King
中科院分区：
文献类型：
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作者：
J. Cavanaugh;Ozaktay Ac;T. Yamashita;A. Avramov;T. Getchell;A. King
几十年来，特发性腰痛一直困扰着医疗保健从业者。导致小关节疼痛、椎间盘源性疼痛和坐骨神经痛的细胞和神经机制还不清楚。为了帮助阐明这些机制，麻醉的新西兰白色兔被用于一系列的神经生理学和神经解剖学研究。这些研究显示了以下证据支持小关节疼痛：小神经纤维和末梢在腰椎小关节中广泛分布，含有P物质的神经，小关节囊中的高阈值机械感受器，以及当神经暴露于炎症或痛觉化学物质时，小关节和周围肌肉中的神经敏感和兴奋。椎间盘源性疼痛的证据包括椎间盘浅环中广泛分布的小神经纤维和游离神经末梢以及相邻纵韧带中的小纤维和游离神经末梢。坐骨神经痛的可能机制包括：当背根神经节受到中等压力时，产生强烈而持久的兴奋性放电;当神经节暴露于自体髓核时，背根纤维兴奋;暴露于磷脂酶A2时，神经根兴奋并丧失神经功能。
Idiopathic low back pain has confounded health care practitioners for decades. The cellular and neural mechanisms that lead to facet pain, discogenic pain, and sciatica are not well understood. To help elucidate these mechanisms, anesthetized New Zealand white rabbits were used in a series of neurophysiologic and neuroanatomic studies. These studies showed the following evidence in support of facet pain: an extensive distribution of small nerve fibers and endings in the lumbar facet joint, nerves containing substance P, high threshold mechanoreceptors in the facet joint capsule, and sensitization and excitation of nerves in facet joint and surrounding muscle when the nerves were exposed to inflammatory or algesic chemicals. Evidence for pain of disc origin included an extensive distribution of small nerve fibers and free nerve endings in the superficial annulus of the disc and small fibers and free nerve endings in adjacent longitudinal ligaments. Possible mechanisms of sciatica included vigorous and long lasting excitatory discharges when dorsal root ganglia were subjected to moderate pressure, excitation of dorsal root fibers when the ganglia were exposed to autologous nucleus pulposus, and excitation and loss of nerve function in nerve roots exposed to phospholipase A2.