CAJ | 학술논문

目的研究腰椎间盘传入神经的投射范围,探讨腰椎间盘源性疼痛的症状发生机制.方法 30只Wistar大鼠,体重250～300 g,雌雄不限.应用随机数字表法随机分为L4-5、L5-6、L6S13组,每组10只；尔后每组随机分为实验组和对照组,每亚组5只.腹腔麻醉下,腰后正中入路牵开神经根显露椎间盘后部,以微量注射器穿刺达纤维环内层,实验组注入质量浓度为30％的霍乱毒素B单位辣根过氧化物酶(cholera toxin-horseradish peroxidase,CT-HRP)2μl,对照组同法注入质量浓度为0.9％的生理盐水2μl.动物存活48 h后行心内灌注后切取T10～L3背根神经节,切片厚度为30 μm.按照DAB法对切片进行成色反应,光镜下观察神经元胞体内或神经纤维内出现棕黑色颗粒为阳性.结果 L4-5、L5-6、L6S1椎间盘注射CT-HRP后,在T10～L3不同范围的背根神经节内均可以观察到CT-HRP标记的棕黑色神经纤维,且不仅局限于单一神经节；椎间盘位置越低,其神经传入的位置也越低.对照组双侧背根神经节内均未见CT-HRP标记的棕黑色神经纤维和神经元.结论腰椎间盘的传入神经投射到T10～L3的背根神经节,这一神经解剖特点是腰椎间盘源性疼痛症状发生机制的基础.
목적 연구요추간반전입신경적투사범위,탐토요추간반원성동통적증상발생궤제.방법 30지Wistar대서,체중250～300 g,자웅불한.응용수궤수자표법수궤분위L4-5、L5-6、L6S13조,매조10지；이후매조수궤분위실험조화대조조,매아조5지.복강마취하,요후정중입로견개신경근현로추간반후부,이미량주사기천자체섬유배내층,실험조주입질량농도위30％적곽란독소B단위랄근과양화물매(cholera toxin-horseradish peroxidase,CT-HRP)2μl,대조조동법주입질량농도위0.9％적생리염수2μl.동물존활48 h후행심내관주후절취T10～L3배근신경절,절편후도위30 μm.안조DAB법대절편진행성색반응,광경하관찰신경원포체내혹신경섬유내출현종흑색과립위양성.결과 L4-5、L5-6、L6S1추간반주사CT-HRP후,재T10～L3불동범위적배근신경절내균가이관찰도CT-HRP표기적종흑색신경섬유,차불부국한우단일신경절；추간반위치월저,기신경전입적위치야월저.대조조쌍측배근신경절내균미견CT-HRP표기적종흑색신경섬유화신경원.결론 요추간반적전입신경투사도T10～L3적배근신경절,저일신경해부특점시요추간반원성동통증상발생궤제적기출.
Objective To demonstrate the project scope of the afferent nerves of the lumbar intervertebral disc,on which basis to explore the mechanism of the symptoms of discgenic low back pain.Methods Thirty Wistar rats were divided randomly into three groups of 10 rats each:the L4-5,L5-6,and L6 S1 group.Each group was further divided randomly into two subgroups,the experimental group and the control group,5 rats for each group.Intervertebral disc was exposed through the posterior approach under peritoneal cavity anesthesia,after the nerve roots were pull away,2 μl of 30％ cholera toxin-horseradish peroxidase (CT-HRP) was injected into the inner layer of the intervertebral disc in the experimental group,while 2 μl of 0.9％ Nacl was used in the control group.Forty-eight hours after the surgery,all rats were perfused and bilateral dorsal root ganglions(DRGs) of T10-L3 were resected and fixxied.Each DRG was sectioned at 30 μm thickness and processed by DAB method.The sections of DRGs were coverslipped and observed by optical microscopy for the neurons or axons labelled by CT-HRP.It was judged as positive that brownish-black particles were in the neurons or axons.Results Not in a single dorsal root ganglions,but in a scope of dorsal root ganglions axons labled by CT-HRP could be seen in the rats in the experimental groups.No CT-HRP labled neurons or axons were seen in dorsal root ganglions in the contral groups.Conclusion Afferent nerves of the lumbar intervertebral disc project to a scope of dorsal root ganglions,which is the anatomic basis of the mechanism of the symptoms of discgenic low back pain.