小鼠单节段腰椎间盘损伤后持续性椎间盘源性轴向和放射痛的延迟发作。

Delayed onset of persistent discogenic axial and radiating pain after a single-level lumbar intervertebral disc injury in mice.

机构信息

Faculty of Dentistry, McGill University, Montreal, QC, Canada.

Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.

出版信息

Pain. 2018 Sep;159(9):1843-1855. doi: 10.1097/j.pain.0000000000001284.

Abstract

Low back pain (LBP) is associated with both axial discomfort and radiating leg pain. Although intervertebral discs are suspected as the source of pain in some individuals, the relationship between disc degeneration and back pain remains controversial. The goals of this study were to investigate the long-term impact of L4/L5 disc puncture on disc degeneration and the subsequent emergence, persistence, and underlying mechanisms of axial and radiating LBP in mice. L4 to L5 discs were punctured on the ventral aspect with a 30 gauge needle in 3-month old female CD1 mice, and the development of behavioral signs of axial discomfort (tail suspension and grip force), radiating hypersensitivity (von Frey and acetone), and motor impairment (rotarod) were monitored. Disc degeneration was assessed using X-ray, T2-magnetic resonance imaging, and histology, and persisted for up to 1 year. Innervation was quantified by immunohistochemistry using the pan-neuronal marker PGP9.5. Behavioural signs of axial discomfort peaked 3 to 9 months after injury. During the peak, local nerve density was increased. A transient increase in hypersensitivity to cold, suggestive of radiating pain, was observed 2 weeks after injury. Radiating pain then reemerged 9 to 12 months after injury in half the animals and correlated with increased dorsal innervation and reduced disc height at these late time points. In summary, a single-level disc injury is sufficient to induce prolonged disc degeneration and delayed axial and radiating pain. This model will be useful to investigate underlying mechanisms and potential therapeutic strategies for discogenic LBP.

摘要

下腰痛(LBP)与轴向不适和放射状腿部疼痛有关。虽然椎间盘被怀疑是某些人疼痛的来源,但椎间盘退变与腰痛之间的关系仍存在争议。本研究的目的是研究 L4/L5 椎间盘穿刺对椎间盘退变的长期影响,以及随后在小鼠中轴向和放射状 LBP 的出现、持续存在和潜在机制。在 3 个月大的雌性 CD1 小鼠的腹侧用 30 号针穿刺 L4 至 L5 椎间盘,并监测轴向不适(尾巴悬挂和握力)、放射状过敏(von Frey 和丙酮)和运动障碍(旋转棒)的行为迹象的发展。使用 X 射线、T2 磁共振成像和组织学评估椎间盘退变,并持续长达 1 年。使用泛神经元标志物 PGP9.5 通过免疫组织化学定量神经支配。轴向不适的行为迹象在受伤后 3 至 9 个月达到峰值。在峰值期间,局部神经密度增加。受伤后 2 周观察到对冷的敏感性短暂增加,提示放射状疼痛。然后,在受伤后 9 至 12 个月,一半的动物重新出现放射状疼痛,这与这些晚期时背部神经支配增加和椎间盘高度降低有关。总之,单次椎间盘损伤足以引起长期的椎间盘退变和延迟的轴向和放射状疼痛。该模型将有助于研究椎间盘源性 LBP 的潜在机制和潜在治疗策略。

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