The role of the vertebral end plate in low back pain.
The role of the vertebral end plate in low back pain.
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DOI：
10.1055/s-0033-1347298
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发表时间：
2013-06
影响因子：
2.4
通讯作者：
Liebenberg EC
中科院分区：
文献类型：
--
作者：
Lotz JC;Fields AJ;Liebenberg EC
终板充当刚性椎体和柔韧椎间盘之间的界面。由于腰椎承受巨大的力，而椎间盘没有专用的血液供应，因此终板必须平衡相互冲突的要求，即坚固以防止椎骨骨折，而多孔以促进椎间盘细胞和椎毛细血管之间的运输。因此，终板特别容易受到损伤，这会增加促炎椎间盘成分和血管化椎骨骨髓之间的通讯。受损的终板区域可能是反应性骨髓损伤的部位，其中包括增殖的神经，这些神经对化学致敏和机械刺激敏感。尽管多项证据表明受神经支配的终板损伤可能是慢性腰痛的根源，但其在患者中的作用可能未被充分认识，因为诊断成像很难观察到受神经支配的损伤。本文献综述总结了终板的生物物理功能和可能导致椎源性疼痛的病理退化的各个方面。未来的研究领域是在慢性腰痛患者未满足的临床需求的背景下确定的。
End plates serve as the interface between rigid vertebral bodies and pliant intervertebral disks. Because the lumbar spine carries significant forces and disks don't have a dedicated blood supply, end plates must balance conflicting requirements of being strong to prevent vertebral fracture and porous to facilitate transport between disk cells and vertebral capillaries. Consequently, end plates are particularly susceptible to damage, which can increase communication between proinflammatory disk constituents and vascularized vertebral bone marrow. Damaged end plate regions can be sites of reactive bone marrow lesions that include proliferating nerves, which are susceptible to chemical sensitization and mechanical stimulation. Although several lines of evidence indicate that innervated end plate damage can be a source of chronic low back pain, its role in patients is likely underappreciated because innervated damage is poorly visualized with diagnostic imaging. This literature review summarizes end plate biophysical function and aspects of pathologic degeneration that can lead to vertebrogenic pain. Areas of future research are identified in the context of unmet clinical needs for patients with chronic low back pain.
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