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由脊髓反射介导的腰椎间盘腹侧部分与腹股沟之间的区域对应关系。盘源性牵涉痛的一种可能基础。

Regional correspondence between the ventral portion of the lumbar intervertebral disc and the groin mediated by a spinal reflex. A possible basis of discogenic referred pain.

作者信息

Takahashi Y, Sato A, Nakamura S I, Suseki K, Takahashi K

机构信息

Department of Orthopaedic Surgery, School of Medicine, Chiba University, Japan.

出版信息

Spine (Phila Pa 1976). 1998 Sep 1;23(17):1853-8; discussion 1859. doi: 10.1097/00007632-199809010-00010.

Abstract

STUDY DESIGN

Lumbar peripheral nerves were examined to determine whether they were responsive to electrical stimulation of the ventral portion of the lumbar disc in anesthetized rats.

OBJECTIVES

To confirm by electrophysiologic means the neural correspondence between the ventral portion of the lumbar disc and the groin.

SUMMARY OF BACKGROUND DATA

Patients with a degenerated lumbar disc occasionally report groin pain. However, its pathogenesis has not been investigated. The authors of the current study found that chemical stimulation of the ventral portion of rat lumbar disc caused cutaneous plasma extravasation in the groin, and thereby hypothesize the neural relation between the lumbar disc and the groin.

METHODS

The ventral portion of rat L5-L6 disc was electrically stimulated, and the elicited action potentials were recorded from the iliohypogastric, genitofemoral, lateral femoral cutaneous, sural, and sciatic nerves. The roles of the lumbar sympathetic trunks and spinal cord in the generation of the action potentials were examined.

RESULTS

Action potentials were elicited principally in the genitofemoral nerve; the action potentials of the genitofemoral nerve were not influenced by transection of the cervical spinal cord, whereas they disappeared immediately after death, which indicates that they are induced by a spinal reflex. The action potentials were reduced considerably after destruction of the lumbar sympathetic trunks, suggesting that they comprise an afferent path of the reflex.

CONCLUSIONS

The ventral portion of the lumbar disc had spatial relation to the groin area via a spinal reflex. Such a relation suggests that a disorder in the ventral portion of the lumbar disc may be a possible source of groin referred pain.

摘要

研究设计

对麻醉大鼠的腰周围神经进行检查,以确定它们是否对腰椎间盘腹侧的电刺激有反应。

目的

通过电生理方法证实腰椎间盘腹侧与腹股沟之间的神经对应关系。

背景资料总结

腰椎间盘退变的患者偶尔会报告腹股沟疼痛。然而,其发病机制尚未得到研究。本研究的作者发现,对大鼠腰椎间盘腹侧进行化学刺激会导致腹股沟皮肤血浆外渗,从而推测腰椎间盘与腹股沟之间的神经关系。

方法

对大鼠L5-L6椎间盘腹侧进行电刺激,并从髂腹下神经、生殖股神经、股外侧皮神经、腓肠神经和坐骨神经记录诱发的动作电位。研究了腰交感干和脊髓在动作电位产生中的作用。

结果

动作电位主要在生殖股神经中诱发;生殖股神经的动作电位不受颈脊髓横断的影响,而在死亡后立即消失,这表明它们是由脊髓反射诱发的。腰交感干破坏后,动作电位明显降低,提示它们构成反射的传入路径。

结论

腰椎间盘腹侧通过脊髓反射与腹股沟区域存在空间关系。这种关系表明,腰椎间盘腹侧的紊乱可能是腹股沟牵涉痛的一个可能来源。

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