Biomechanical Mechanisms of Facet Whiplash Injury & Pain

小关节颈椎扭伤损伤的生物力学机制

基本信息

批准号：
7018840
负责人：
Beth A Winkelstein
金额：
$ 27.96万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-08-30 至 2008-08-29
项目状态：
已结题

项目摘要

DESCRIPTION (adapted from applicant's abstract): Whiplash and its associated syndromes continue to be ranked among the most common and debilitating nonfatal injuries. The facet joint has been identified as having the potential to undergo subfailure mechanical injury for motions the neck experiences during whiplash. Also, its neurophysiologic anatomy suggests its ability to generate pain for extreme loading. However, little is known about the effects of these local joint mechanics, such as tension and compression that are experienced in whiplash, on pain symptoms or signaling mechanisms. Purpose of Proposed Research: The lonq-term objective of this application is to define the mechanical conditions for dynamic facet joint loading that cause persistent pain symptoms, and to correlate behavioral outcomes with cellular reactivity in the spinal cord. Mechanical thresholds will provide the foundation to develop guidelines to reduce the incidence of painful whiplash injuries in the general population. They will also guide modifications to the automobile and occupant-use habits to reduce risks for these injuries. Methods: In the proposed research plan, there will be integration of biomechanics, behavioral test instruments and biochemical assays to link pain pathways with mechanical loading of the cervical facet joint. Using a new micromechanical device developed in this laboratory, the investigators will apply controlled distraction(s) and compression(s) of the facet joint and study the onset of a graded persistent pain response in the rat. It is hypothesized that: 1) dynamic facet joint distraction mimicking that observed in whiplash simulations will produce persistent behavioral hypersensitivity; 2) facet joint compression producing capsule pinch is sufficient to initiate persistent pain; and 3) for injury conditions above the threshold for producing pain, cellular reactivity responses of nociception and glial activation in the spinal cord will be produced and sustained. Implications for Prevention: By accomplishing the specific aims of the research, the investigators will directly link the initial mechanical conditions of the facet joint to pain pathways in the CNS. In turn, they will define the etiology for persistent pain due to dynamic joint motions, leading to the development and recommendations for future design interventions and behavioral modifications to prevent these injuries. Relevance: Whiplash is a tremendous public health problem and a common injury for vehicle occupants, with staggering annual societal and financial burdens. This research proposal will define the mechanical thresholds for painful facet injuries in the neck and investigate the effects of biomechanical risk factors, such as loading direction, on exacerbating pain. Physiologic correlates of these injuries and symptoms are also characterized for guiding future development of preventions and treatments for neck pain.

描述（根据申请人的摘要改编）：Whiplash及其相关综合症仍然被评为最常见和令人衰弱的非致命伤害。该方面的关节被确定为有可能在鞭打过程中进行颈部经历的运动体经历。同样，其神经生理解剖学表明，它有能力产生极端负荷的疼痛。但是，对于这些局部关节力学的影响，例如鞭打，疼痛症状或信号传导机制中经历的张力和压缩的影响知之甚少。拟议研究的目的：本应用的LONQ期限目标是定义导致持续性疼痛症状的动态方面关节负荷的机械条件，并将行为结果与脊髓中的细胞反应性相关联。机械阈值将为制定指南提供基础，以减少普通人群中痛苦鞭打伤害的发生率。他们还将指导对汽车和使用乘员习惯的修改，以减少这些伤害的风险。方法：在拟议的研究计划中，将整合生物力学，行为测试仪器和生化测定法，以将疼痛途径与颈椎相结合的机械负荷联系起来。使用该实验室开发的新的微机械设备，研究人员将采用刻布接头的受控分散注意力和压缩，并研究大鼠分级持续疼痛反应的发作。假设：1）模仿鞭打模拟中观察到的动态方面关节分散注意力会产生持续的行为超敏反应； 2）产生胶囊捏合的小平面关节压缩足以引发持续的疼痛； 3）对于高于产生疼痛阈值的损伤条件，将产生并维持脊髓中伤害感受和神经胶质激活的细胞反应性反应。对预防的影响：通过实现研究的具体目的，研究人员将直接将小方关节的初始机械条件与中枢神经系统的疼痛途径联系起来。反过来，他们将因动态关节动作而定义持续性疼痛的病因，从而导致对未来设计干预措施和行为修改的发展和建议，以防止这些伤害。相关性：鞭打是一个巨大的公共卫生问题，对车辆乘员来说是一个常见的伤害，年度社会和财务负担惊人。这项研究建议将定义颈部疼痛疼痛的机械阈值，并研究生物力学危险因素（例如加载方向）对加剧疼痛的影响。这些损伤和症状的生理相关性也是指导未来开发颈部疼痛的预防和治疗方法的特征。