Department of Orthopaedics, Pamukkale University School of Medicine, Denizli, Turkey.
Spine (Phila Pa 1976). 2010 Feb 15;35(4):E101-4. doi: 10.1097/BRS.0b013e3181ae561d.
STUDY DESIGN: Immunohistochemical study on fresh cadaver specimens. OBJECTIVE: Assessment of mechanoreceptor and nociceptor levels and distribution in iliolumbar ligament. SUMMARY AND BACKGROUND DATA: The function of iliolumbar ligament and its role in low back pain has not been yet fully clarified. Understanding the innervation of this ligament should provide a ground which enables formation of stronger hypotheses. METHODS: Bilateral 30 iliolumbar ligaments of 15 fresh cadavers were included in the study. Morphologic properties were recorded and the ligaments were examined by focusing on 3 main parts: ligament, bone insertions, and tendon body. Assessment of mechanoreceptor and nociceptor levels and their distribution in iliolumbar ligament were performed on the basis of immunohistochemistry using the S-100 antibody specific for nerve tissue. RESULTS: Iliac wing insertion was found to be the richest region of the ligament in terms of mechanoreceptors and nociceptors. Pacinian (type II) mechanoreceptor was determined to be the most common (66.67%) receptor followed by Ruffini (type I) (19.67%) mechanoreceptor, whereas free nerve endings (type IV) and Golgi tendon organs (type III) were found to be less common, 10.83% and 2.83%, respectively. CONCLUSION: Immunohistochemical staining has shown that iliolumbar ligament had a rich nerve tissue. Those results indicate that ILL plays an important role in proprioceptive coordination of lumbosacral region alongside its known biomechanic support function. Moreover, the presence of type IV nerve endings suggest that the injury of this ligament might contribute to the low back pain.
研究设计:对新鲜尸体标本进行免疫组织化学研究。 目的:评估髂腰韧带中机械感受器和伤害感受器的水平和分布。 摘要和背景数据:髂腰韧带的功能及其在腰痛中的作用尚未完全阐明。了解该韧带的神经支配应该为形成更强的假设提供基础。 方法:纳入 15 例新鲜尸体的 30 个双侧髂腰韧带。记录形态学特征,并通过关注 3 个主要部分:韧带、骨插入和腱体,检查韧带:评估髂腰韧带中机械感受器和伤害感受器的水平及其分布,采用 S-100 抗体对神经组织进行免疫组织化学染色。 结果:髂翼插入部是韧带中机械感受器和伤害感受器最丰富的区域。帕西尼(II 型)机械感受器被确定为最常见的(66.67%)感受器,其次是鲁菲尼(I 型)(19.67%)机械感受器,而游离神经末梢(IV 型)和高尔基腱器官(III 型)则较少见,分别为 10.83%和 2.83%。 结论:免疫组织化学染色显示髂腰韧带具有丰富的神经组织。这些结果表明,髂腰韧带在腰骶区的本体感觉协调中发挥着重要作用,除了其已知的生物力学支撑功能外。此外,IV 型神经末梢的存在表明该韧带的损伤可能导致腰痛。
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