Takahashi Kazuhisa, Aoki Yasuchika, Ohtori Seiji
Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba, Chiba, 260-8677, Japan.
Eur Spine J. 2008 Dec;17 Suppl 4(Suppl 4):428-31. doi: 10.1007/s00586-008-0752-4. Epub 2008 Nov 13.
Recent basic science studies on discogenic low back pain have provided new knowledge about this condition. This paper reviews some of these results and presents an overview of the following findings. The rat lumbar intervertebral disk may be innervated non-segmentally through the paravertebral sympathetic nerve and segmentally through the sinuvertebral nerves, and also by dichotomizing sensory fibers. The exposure of the nucleus pulposus (NP) to the outer annulus fibrosus (AF) may induce nerve injury and ingrowth into the disk. Nerve growth factor (NGF)-sensitive neurons are predominant in the rat intervertebral disk, which indicates that hyperalgesic responses can be induced by inflammation. NGF in the NP may promote axonal growth. Lumbar fusion may inhibit nerve ingrowth into the degenerated disk and reduce the percentage of calcitonin gene related peptide (CGRP)-positive neurons.
近期关于椎间盘源性下腰痛的基础科学研究为这种疾病提供了新知识。本文回顾了其中一些研究结果，并概述了以下发现。大鼠腰椎间盘可能通过椎旁交感神经非节段性地接受神经支配，通过窦椎神经节段性地接受神经支配，并且也通过感觉纤维的二分法接受神经支配。髓核（NP）暴露于纤维环外层（AF）可能会导致神经损伤并长入椎间盘。神经生长因子（NGF）敏感神经元在大鼠椎间盘中占主导地位，这表明炎症可诱导痛觉过敏反应。NP中的NGF可能促进轴突生长。腰椎融合术可能会抑制神经长入退变的椎间盘，并降低降钙素基因相关肽（CGRP）阳性神经元的比例。
