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Possible mechanism of painful radiculopathy in lumbar disc herniation.

AUTHORS:

Kawakami M; Tamaki T; Hayashi N; Hashizume H; Nishi H

AUTHOR AFFILIATION:

Department of Orthopedic Surgery, Wakayama Medical College, Japan.

SOURCE:

Clin Orthop 1998 Jun;(351):241-51

CITATION IDS:

PMID: 9646768 UI: 98310736

ABSTRACT:

The pathophysiologic mechanisms of painful radiculopathy caused by a herniated intervertebral disc remain unknown. This study sought to determine whether the autologous intervertebral disc produces pain related behavior and whether phospholipase A2 and nitric oxide are involved in the pathophysiologic mechanism producing the behavior. A rat model, in which autologous intervertebral discs were implanted on the nerve root in the lumbar spine, was used to measure hyperalgesia, which is a pain related behavior in the rat. In this experimental model, autologous nucleus pulposus and anulus fibrosus transplanted to lumbar nerve roots produced mechanical and thermal hyperalgesia, respectively. Epidural injection of a selective inhibitor for phospholipase A2 resulted in the disappearance of hypersensitivity to noxious mechanical stimuli. Thermal hyperalgesia produced by application of the anulus fibrosus was abated and abolished by epidural injections of saline and one of the inhibitors for nitric oxide synthase, respectively. The authors suggest that chemical mediators such as phospholipase A2 and nitric oxide, induced by extruded or sequestrated intervertebral discs, are involved in the pathophysiologic mechanisms of painful radiculopathy in lumbar disc herniations. This study may be useful in attempting to develop new medical approaches for treatments of lumbar disc herniation.

MAIN MESH HEADINGS:

Hyperalgesia/*etiology
Intervertebral Disk Displacement/*complications
Lumbar Vertebrae/*injuries
Peripheral Nervous System Diseases/*etiology
*Spinal Nerve Roots

ADDITIONAL MESH HEADINGS:

Analysis of Variance
Animal
Comparative Study
Disease Models, Animal
Hyperalgesia/enzymology
Hyperalgesia/physiopathology
Intervertebral Disk Displacement/enzymology
Intervertebral Disk Displacement/physiopathology
Lumbar Vertebrae/innervation
Male
Nitric-Oxide Synthase/antagonists & inhibitors
Nitric-Oxide Synthase/metabolism
Pain Threshold/physiology
Peripheral Nervous System Diseases/enzymology
Peripheral Nervous System Diseases/physiopathology
Phospholipases A/antagonists & inhibitors
Phospholipases A/metabolism
Rats
Rats, Sprague-Dawley
Reaction Time/physiology
Support, Non-U.S. Gov't

PUBLICATION TYPES:

JOURNAL ARTICLE

CAS REGISTRY NUMBERS:

EC 1.14.13.39 (Nitric-Oxide Synthase)
EC 3.1.1.- (Phospholipases A)

LANGUAGES:

Eng