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脊柱感觉神经支配在腰背痛中的作用:综述与临床评论

Contribution of the sensory innervation of the spine in low back pain: review and clinical commentary.

作者信息

Viseux Frederic J F, Mora Annarita, Villeneuve Philippe, Charpentier Pascal, Martins Daniel F, Lemaire Antoine

机构信息

Centre d'évaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France.

Service de Neurochirurgie, Centre Hospitalier de Valenciennes, Valenciennes, France.

出版信息

Somatosens Mot Res. 2021 Mar;38(1):27-33. doi: 10.1080/08990220.2020.1840344. Epub 2020 Oct 27.

Abstract

Few validated tests allow a precise aetiological diagnosis of Low Back Pain (LBP), and the difficulty of clinical evaluations could be one of the reasons to explain the lack of effectiveness in the therapeutic management of chronic LBP. However, an implication of a sensory impairment in the control of sensorimotor circuits could be suggested. Interactive and specific responses between nociceptive nerve fibres and the paraspinal musculature motor control could have clinical implications, in particular through kinematic evaluation. Following an introduction to the link between the sensory innervation of the spine and pain, we then summarise the maladaptive movement in LBP at the kinematic and neuropathological level. A clinical objectification of these kinematic adaptations at the lumbar spine level, would clarify the aetiological diagnosis causes of chronic LBP, and so help optimising therapeutic strategies by proposing a relevant and precise clinical model of this painful condition.

摘要

很少有经过验证的测试能够对腰痛(LBP)进行精确的病因诊断,临床评估的困难可能是慢性腰痛治疗管理缺乏有效性的原因之一。然而,可以推测感觉障碍在感觉运动回路控制中存在影响。伤害性神经纤维与椎旁肌肉组织运动控制之间的交互和特定反应可能具有临床意义,特别是通过运动学评估。在介绍了脊柱感觉神经支配与疼痛之间的联系之后,我们接着总结了腰痛在运动学和神经病理学层面的适应不良运动。在腰椎水平对这些运动学适应进行临床客观化,将有助于阐明慢性腰痛的病因诊断原因,从而通过提出这种疼痛状况的相关且精确的临床模型来帮助优化治疗策略。

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