Radicular pain - Recent pathophysiologic concepts and therapeutic implications [Radikuläre schmerzen - Aktuelle pathophysiologische konzepte und therapeutische implikationen]

被引:0
作者
Olmarker K. [1 ]
机构
[1] Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg University
关键词
Cytokines; Intervertebral disk; Nerve root; Neuropathic pain; Sciatica;
D O I
10.1007/s004820100027
中图分类号
学科分类号
摘要
Studies have been performed to elucidate the pathophysiologic mechanisms leading to sciatica. The studies comprise assessment of structural and functional changes as well as pain and have shown that the intervertebral disk (nucleus pulposus) may induce changes in a nerve root after local application in the absence of a mechanical component. Such changes may for the first time present a biologic or biochemical basis for the development of sciatica. Disk-related cytokines, in particular tumor necrosis factor (TNF), have been found to mediate such changes,and clinical trials have now been initiated to assess the possibility of treating sciatica with selective inhibition of TNF.
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页码:425 / 429
页数:4
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  • [1] Arai I., Mao G.P., Otani K., Et al., Indomethacin blocks nucleus pulposus-related effects in adjacent nerve roots, Eur Spine J, (2001)
  • [2] Arai I., Konno S., Otani K., Et al., Cyclosporin A blocks the toxic effects of nucleus pulposus on spinal nerve roots, (2001)
  • [3] Bailey P., Casamajor L., Osteo-arthritis of the spine as a cause of compression of the spinal cord and its roots. With report of 5 cases, J Nerv Ment Dis, 38, pp. 588-609, (1911)
  • [4] Bayliss M.T., Johnstone B., Biochemistry of the intervertebral disc, The lumbar spine and back pain, pp. 111-131, (1992)
  • [5] Byrod G., Olmarker K., Nordborg, Et al., Early effects of nucleus pulposus application on spinal nerve root morphology and function, Eur Spine J, 7, pp. 445-449, (1998)
  • [6] Byrod G., Otani K., Brisby H., Et al., Methylprednisolone reduces the early vascular permeability increase in spinal nerve roots induced by epidural nucleus pulposus application, J Orthop Res, 18, 6, pp. 983-987, (2001)
  • [7] Byrod G., Rydevik B., Johansson B.R., Et al., Transport of epidurally applied horseradish peroxidase to the endoneurial space of doral root ganglia: A light and electron microscopic study, J Per Nerv Syst, 5, 1, pp. 218-226, (2001)
  • [8] Dawson J., Hurtenbach U., MacKenzie A., Cyclosporin A inhibits the in vivo production of interleukin-1beta and tumor necrosis factor alpha, but not interleukin-6, by a T-cell-independent mechanism, Cytokine, 8, pp. 882-888, (1996)
  • [9] Diamant B., Karlsson J., Nachemson A., Correlation between lactate levels and pH in discs of patients with lumbar rhizopathies, Experienta, 24, pp. 1195-1196, (1968)
  • [10] Eyre D., Benya P., Buckwalter J., Et al., Basic science perspectives: Chapter 5. Intervertebral disc, New perspectives on low back pain, pp. 149-207, (1988)