Mosley Grace E, Evashwick-Rogler Thomas W, Lai Alon, Iatridis James C
Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York.
Ann N Y Acad Sci. 2017 Dec;1409(1):51-66. doi: 10.1111/nyas.13429. Epub 2017 Aug 10.
Orthopedic research into chronic discogenic back pain has commonly focused on aging- and degeneration-related changes in intervertebral disc structure, biomechanics, and biology. However, the primary spine-related reason for physician office visits is pain. The ambiguous nature of the human condition of discogenic low back pain motivates the use of animal models to better understand the pathophysiology. Discogenic back pain models must consider both emergent behavioral changes following pain induction and changes in the nervous system that mediate such behavior. Looking beyond the intervertebral disc, we describe the different ways to classify pain in human patients and animal models. We describe several behavioral assays that can be used in rodent models to augment disc degeneration measurements and characterize different types of pain. We review rodent models of discogenic pain that employed behavioral pain assays and highlight a need to better integrate neuroscience and orthopedic science methods to extend current understanding of the complex and multifactorial pathophysiology of discogenic back pain.
对慢性椎间盘源性下腰痛的骨科研究通常集中于椎间盘结构、生物力学和生物学方面与衰老及退变相关的变化。然而,患者前往医生办公室就诊的主要脊柱相关原因是疼痛。椎间盘源性下腰痛这种人类病症的模糊特性促使人们使用动物模型来更好地理解其病理生理学。椎间盘源性疼痛模型必须同时考虑疼痛诱导后出现的行为变化以及介导此类行为的神经系统变化。跳出椎间盘的范畴,我们描述了在人类患者和动物模型中对疼痛进行分类的不同方法。我们介绍了几种可用于啮齿动物模型的行为测定方法,以补充椎间盘退变测量并表征不同类型的疼痛。我们回顾了采用行为疼痛测定方法的椎间盘源性疼痛啮齿动物模型,并强调需要更好地整合神经科学和骨科科学方法,以扩展目前对椎间盘源性下腰痛复杂多因素病理生理学的理解。