腰椎神经根痛的病理基础。
Pathologic Basis of Lumbar Radicular Pain.
机构信息
Department of Neurosurgery, St George Hospital, Sydney, Australia; Department of Neurosurgery, Waikato Hospital, Hamilton, New Zealand; School of Medicine, University of Sydney, Sydney, Australia.
Department of Neurosurgery, St George Hospital, Sydney, Australia; Department of Neurosurgery, St George Private Hospital, Sydney, Australia; Department of Medicine, University of New South Wales, Sydney, Australia.
出版信息
World Neurosurg. 2019 Aug;128:114-121. doi: 10.1016/j.wneu.2019.04.147. Epub 2019 Apr 25.
BACKGROUND
Lumbar radicular pain is one of the most commonly encountered clinical syndromes; however, its underlying mechanistic basis, and its relation to the natural history of the disease, are poorly understood.
METHODS
We revieved the available literature to explore the pathophysiology and natural history of lumbar radicular pain.
RESULTS
Experimental observations have spawned distinctive, but not mutually exclusive, pathophysiologic descriptions of radicular pain. These mechanisms include mechanical compression and inflammatory processes. In most cases, a complex interplay between these mechanisms is required to sustain the pain. However, when the dorsal root ganglion is mechanically deformed, sustained discharges causing pain can be evoked, leading to pain based on a purely mechanical basis. However, in other instances, previous sensitization of the nerve root by inflammatory processes is required.
CONCLUSION
An understanding of these processes and the natural history of the syndrome is important to developing therapeutic strategies.
背景
腰椎神经根痛是最常见的临床综合征之一；然而，其潜在的发病机制及其与疾病自然史的关系尚不清楚。
方法
我们查阅了现有文献，以探讨腰椎神经根痛的病理生理学和自然史。
结果
实验观察产生了独特的、但不相互排斥的神经根痛病理生理学描述。这些机制包括机械压迫和炎症过程。在大多数情况下，需要这些机制的复杂相互作用来维持疼痛。然而，当背根神经节受到机械变形时，会引起持续的放电引起疼痛，导致基于纯粹机械基础的疼痛。然而，在其他情况下，需要先前的炎症过程对神经根的致敏作用。
结论
了解这些过程和综合征的自然史对于制定治疗策略很重要。
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