Mense Siegfried
Department of Neurophysiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Eur J Transl Myol. 2019 Sep 6;29(3):8297. doi: 10.4081/ejtm.2019.8297. eCollection 2019 Aug 2.
The aim of the study was to obtain information on the sensory functions of the thoracolumbar fascia (TLF). The types of nerve fibres present in the TLF were visualized with specific antibodies to neuropeptides and sympathetic fibres. Most data were obtained from the TLF in rats, but some findings from the human fascia are also included. The only receptive nerve ending found was the free nerve ending, i.e. no corpuscular receptors existed in our specimen. An exclusive innervation with free nerve endings speaks for a nociceptive function, but the TLF may also fulfill proprioceptive functions, since many of the free nerve endings have a low mechanical threshold. Most of the fibres could be visualized with antibodies to CGRP [calcitonin gene- related peptide (CGRP)] and SP [substance P (SP)]. The latter ones most likely were nociceptors. The TLF contained a great proportion of postganglionic sympathetic fibres, which may be vasoconstrictors. A comparison between an inflamed and intact fascia showed an increase of the CGRP- and SP-positive fibres in the inflamed TLF. This finding could be one explanation for the low back pain of many patients, since practically all lesions of the fascia are accompanied by a sterile inflammation.
本研究的目的是获取有关胸腰筋膜(TLF)感觉功能的信息。使用针对神经肽和交感神经纤维的特异性抗体,观察TLF中存在的神经纤维类型。大部分数据来自大鼠的TLF,但也包括一些人体筋膜的研究结果。唯一发现的感受神经末梢是游离神经末梢,即我们的标本中不存在小体感受器。游离神经末梢的独特支配表明其具有伤害感受功能,但TLF也可能具有本体感受功能,因为许多游离神经末梢的机械阈值较低。大多数纤维可以用抗降钙素基因相关肽(CGRP)和P物质(SP)的抗体观察到。后者很可能是伤害感受器。TLF含有很大比例的节后交感神经纤维,可能具有血管收缩作用。对比发炎的筋膜和完整的筋膜发现,发炎的TLF中CGRP和SP阳性纤维增加。这一发现可能是许多患者腰痛的一个原因,因为实际上所有筋膜损伤都伴有无菌性炎症。