Lee Kathryn E, Thinnes John H, Gokhin David S, Winkelstein Beth A
Department of Bioengineering, University of Pennsylvania, 120 Hayden Hall, 3320 Smith Walk, Philadelphia, PA 19104-6392, USA.
J Neurosci Methods. 2004 Aug 30;137(2):151-9. doi: 10.1016/j.jneumeth.2004.02.021.
Clinical, epidemiological, and biomechanical studies suggest involvement of cervical facet joint injuries in neck pain. While bony motions can cause injurious tensile facet joint loading, it remains speculative whether such injuries initiate pain. There is currently a paucity of data explicitly investigating the relationship between facet mechanics and pain physiology. A rodent model of tensile facet joint injury has been developed using a customized loading device to apply two separate tensile deformations (low, high; n = 5 each) across the C6/C7 joint, or sham (n = 6) with device attachment only. Microforceps were rigidly coupled to the vertebrae for distraction and joint motions tracked in vivo. Forepaw mechanical allodynia was measured postoperatively for 7 days as an indicator of behavioral sensitivity. Joint strains for high (33.6 +/- 3.1%) were significantly elevated (P < 0.005) over low (11.1 +/- 2.3%). Digitization errors (0.17 +/- 0.20%) in locating bony markers were small compared to measured strains. Allodynia was significantly elevated for high over low and sham for all postoperative days. However, allodynia for low injury was not different than sham. A greater than three-fold increase in total allodynia resulted for high compared to low, corresponding to the three-fold difference in injury strain. Findings demonstrate tensile facet joint loading produces behavioral sensitivity that varies in magnitude according to injury severity. These results suggest that a facet joint tensile strain threshold may exist above which pain symptoms result. Continued investigation into the relationship between injury mechanics and nociceptive physiology will strengthen insight into painful facet injury mechanisms.
临床、流行病学和生物力学研究表明,颈椎小关节损伤与颈部疼痛有关。虽然骨骼运动可导致小关节承受有害的拉伸负荷,但此类损伤是否引发疼痛仍属推测。目前缺乏明确研究小关节力学与疼痛生理学之间关系的数据。利用定制加载装置对C6/C7关节施加两种不同的拉伸变形(低、高;每组n = 5),或仅进行假手术(n = 6,仅附着装置),建立了小关节拉伸损伤的啮齿动物模型。将微型镊子牢固地连接到椎骨上以进行牵张,并在体内跟踪关节运动。术后7天测量前爪机械性异常性疼痛,作为行为敏感性指标。高负荷组(33.6 +/- 3.1%)的关节应变显著高于低负荷组(11.1 +/- 2.3%)(P < 0.005)。与测量应变相比,定位骨标志物时的数字化误差(0.17 +/- 0.20%)较小。术后所有天数,高负荷组的异常性疼痛均显著高于低负荷组和假手术组。然而,低损伤组的异常性疼痛与假手术组无差异。与低负荷组相比,高负荷组的总异常性疼痛增加了三倍多,与损伤应变的三倍差异相对应。研究结果表明,小关节拉伸负荷会产生行为敏感性,其程度根据损伤严重程度而变化。这些结果表明,可能存在一个小关节拉伸应变阈值,超过该阈值会导致疼痛症状。对损伤力学与伤害感受生理学之间关系的持续研究将加强对疼痛性小关节损伤机制的认识。