Kääpä E, Grönblad M, Holm S, Liesi P, Murtomäki S, Vanharanta H
Department of Physical Medicine and Rehabilitation, University of Oulu, Finland.
Eur Spine J. 1994;3(3):137-42. doi: 10.1007/BF02190574.
There is increasing evidence that-back pain may originate from degenerated or damaged disks, even in the absence of disk herniation. For a study of the pattern of innervation in injured disks, the anterior part of the annulus fibrosus of a lumbar disk in 11 domestic pigs was incised with a scalpel through a retroperitoneal approach. The animals were killed 2 weeks, 1, 2, 3, and 5 months postoperatively, and the whole anterior annulus of each injured disk and corresponding tissue from intact animals were excised. Cryostat sections 20 microns thick were cut from the surface downward, fixed, and stained with different antisera. Antisera to neurofilament triplet protein (R39), protein gene product (PGP) 9.5 and synaptophysin were used as general neural markers. Antiserum to substance P (SP) and calcitonin gene-related peptide (CGRP) were used to localize nerves mainly of the sensory type, and C flanking peptide of neuropeptide Y (CPON) to visualize nerve fibers of the sympathetic type. It was observed that in the intact porcine disk, the outer and middle parts of the anterior annulus were innervated to a depth of 7 mm from the annular surface, but the innermost annular layers showed no immunoreactivity to any of the neural antibodies. Disk injury did not cause any major changes in the nerve topography of the wound area, even though there were granulation tissue and neovascularization in this area.
越来越多的证据表明，背痛可能源于椎间盘退变或损伤，即使在没有椎间盘突出的情况下也是如此。为了研究损伤椎间盘的神经支配模式，采用腹膜后入路，用手术刀切开11头家猪腰椎间盘纤维环的前部。术后2周、1个月、2个月、3个月和5个月处死动物，切除每个损伤椎间盘的整个前纤维环以及来自完整动物的相应组织。从表面向下切取20微米厚的冰冻切片，固定并用不同的抗血清染色。使用抗神经丝三联体蛋白（R39）、蛋白基因产物（PGP）9.5和突触素的抗血清作为一般神经标记物。使用抗P物质（SP）和降钙素基因相关肽（CGRP）的抗血清来定位主要为感觉型的神经，使用神经肽Y的C端侧翼肽（CPON）来观察交感型神经纤维。观察到在完整的猪椎间盘中，前纤维环的外层和中层在距纤维环表面7毫米的深度内有神经支配，但最内层纤维环对任何神经抗体均无免疫反应。尽管伤口区域有肉芽组织和新血管形成，但椎间盘损伤并未导致伤口区域神经形态发生任何重大变化。
