摘要
目的：探讨间盘源性下腰痛的发生机制。方法：（1）辣根过氧化物酶（HRP）逆行追踪法：取成年Wistar大鼠随机分成3组（保留腰椎旁交感干组、切断腰椎旁交感干组及自身对照），每组7只。分别于L5-6椎间盘右后侧壁注入HRP，48h后取双侧L1、L2脊神经节制片，观察脊神经节内HRP标记细胞及切除腰椎旁交感干对HRP标记细胞数的影响。（2）荧光素逆行双标法和免疫组化方法：取成年Wistar大鼠7只，荧光素快蓝（FB）注入右侧第二腰神经后支，荧光素核黄（NY）注入L，．。间盘右后侧壁，观察右侧L2脊神经节内荧光素双标细胞；在有荧光素双标细胞的切片上进行免疫组化检查。结果：（1）各组大鼠双侧L1、L2脊神经节中均发现HRP标记细胞，当切断腰椎旁交感干后，脊神经节内HRP标记细胞数明显减少；（2）在右侧L2脊神经节内发现荧光素双标细胞；部分荧光素双标细胞含有降钙素基因相关肽（CGRP）。结论：间盘源性下腰痛可能是一种由腰椎间盘病变引起的，经交感神经传递的，主要累及L1、L2腰神经后支节段性支配区域（下腰区）的牵涉性疼痛。腰椎旁交感干内的交感神经纤维对疼痛的传导是间盘源性下腰痛发生的重要环节。
Objective ： To investigate the mechanism of discogenic low back pain. Methods ： （ 1 ） Rats were divided into experimental group （paravertebral sympathetic trunks were reserved）, control group （paravertebral sympathetic trunks were resected） and self-control group randomly （n = 7）. Horseradish peroxidase （HRP） was injected into the L5-6 intervertebral discs from right postero-lateral side. Bilateral L1, L2 spinal ganglia were sectioned after 48 hours to examine the HRP labeled cells and the effect of resection of paravertebral sympathetic trunks. （2） Fast blue（FB） was injected into the dorsal rami of L2 spinal nerves on the right side, and nuclear yellow （NY） into the right posterior portion of L5-6 intervertebral disc （n = 7）. Combining method stained the sections contained the fluorescent double labelled cells with immunohistochemistry. Results： （1）HRP labeled cells were found in bilateral L1, L2 spinal ganglia in each group. The number of HRP-labeled cells was significantly less than that after resection of paravertebral sympathetic trunks. （2） Fluorescent double labelled cells were found in the dorsal root ganglia of L2 on the right side. Some of them were confirmed to contain calcitonin gene-related peptide （CGRP）. Conclusion： Discogenic low back pain might be a referred pain which is caused by lumbar intervertebral discs diseases, and transmitted by sympathetic nerves. It involves the area that is segmentally innervated by dorsal rami of L1, L2 spinal nerves.
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2007年第1期32-35,共4页
Chinese Journal of Pain Medicine
关键词
椎旁交感干
脊神经节
下腰痛
牵涉痛
Paravertebral sympathetic trunk
Spinal ganglia
Low back pain
Referred pain
