Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
Human Anatomy and Movement Science, University of Padua, Padua, Italy.
Eur Spine J. 2022 Jul;31(7):1879-1888. doi: 10.1007/s00586-022-07235-6. Epub 2022 May 27.
Proprioceptive deficits are common in low back pain. The multifidus muscle undergoes substantial structural change after back injury, but whether muscle spindles are affected is unclear. This study investigated whether muscle spindles of the multifidus muscle are changed by intervertebral disc (IVD) degeneration in a large animal model.
IVD degeneration was induced by partial thickness annulus fibrosus lesion to the L3-4 IVD in nine sheep. Multifidus muscle tissue at L4 was harvested at six months after lesion, and from six age-/sex-matched naïve control animals. Muscle spindles were identified in Van Gieson's-stained sections by morphology. The number, location and cross-sectional area (CSA) of spindles, the number, type and CSA of intrafusal fibers, and thickness of the spindle capsule were measured. Immunofluorescence assays examined Collagen I and III expression.
Multifidus muscle spindles were located centrally in the muscle and generally near connective tissue. There were no differences in the number or location of muscle spindles after IVD degeneration and only changes in the CSA of nuclear chain fibers. The thickness of connective tissue surrounding the muscle spindle was increased as was the expression of Collagen I and III.
Changes to the connective tissue and collagen expression of the muscle spindle capsule are likely to impact their mechanical properties. Changes in capsule stiffness may impact the transmission of length change to muscle spindles and thus transduction of sensory information. This change in muscle spindle structure may explain some of the proprioceptive deficits identified with low back pain.
下腰痛患者常存在本体感觉缺失。背伤后多裂肌发生明显结构改变,但肌梭是否受影响尚不清楚。本研究通过大动物模型探讨椎间盘(IVD)退变是否会改变多裂肌的肌梭。
通过对 L3-4 IVD 纤维环的部分厚度损伤,在 9 只绵羊中诱导 IVD 退变。在损伤后 6 个月,从 L4 多裂肌组织中采集组织,并从 6 只年龄/性别匹配的无损伤对照动物中采集组织。通过形态学鉴定 Van Gieson 染色切片中的肌梭。测量肌梭的数量、位置和横截面积(CSA)、梭内纤维的数量、类型和 CSA 以及梭囊的厚度。免疫荧光检测胶原 I 和胶原 III 的表达。
多裂肌肌梭位于肌肉中心,通常靠近结缔组织。IVD 退变后肌梭的数量和位置没有差异,只有核链纤维 CSA 发生变化。围绕肌梭的结缔组织厚度增加,胶原 I 和胶原 III 的表达增加。
肌梭囊的结缔组织和胶原表达的变化可能会影响其力学特性。囊刚度的变化可能会影响到肌梭的长度变化的传递,从而影响感觉信息的转换。肌梭结构的这种变化可能解释了一些与腰痛相关的本体感觉缺失。