Patchy Osteoporosis in Complex Regional Pain Syndrome

Park, Geun-Young; Im, Sun; Lim, Seong Hoon

doi:10.5772/29181

Cited by 1 publication

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“…В последние два десятилетия исследования костной иннервации интенсифицировались [3]: доказано опосредованное нейротрансмиттерами, нейропептидами, аксональными факторами роста и нейротрофинами участие периферических нервов в развитии и репарации костей [4], изучена нейральная регуляция функции остеобластов и остеокластов в норме и в условиях патологии, прежде всего при остеопорозе [5,6,7]. Установлено, что патогенез «пятнистого» остеопороза при посттравматическом комплексном регионарном болевом синдроме, ранее известном под терминами «рефлекторная симпатическая дистрофия» и «каузалгия» (у пациентов с повреждениями периферических нервов), включает участие не только периферической, но и центральной нервной системы [8]. Рентгенологически «пятнистый» остео пороз выявляется чаще в области кистей и стоп, поражая преимущественно субхондральную кость.…”

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Structural Reorganization of the Third Metatarsal Bone Shaft After Autogenous Plasty of the Tibial Portion of the Sciatic Nerve

Ступина¹,

Щудло²,

Варсегова³

2023

Traumatology and Orthopedics of Russia

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Introduction. The effect of sciatic nerve neurectomy on the loss of bone density of the femur and tibia has been proven in experimental biological models, but the condition of the bones of the distal limb parts after surgeries, aimed at innervation restoring has not been studied. Purpose to reveal structural changes in the shaft of the third metatarsal bone after primary autogenous plasty of the resection defect of the tibial portion of the sciatic nerve in rats. Materials and Methods. Autologous neuroplasty of the tibial portion of the sciatic nerve was performed in 16 Wistar rats (aged 8-10 months). In 4 and 6 months after the surgery, the animals were euthanized, control 7 intact rats of the appropriate age at the time of euthanasia. The ratio of fuchsinophilic and anilinophilic structures of the cortical plate was determined using the method of point-count volumemetry in the images of the transverse sections of the third metatarsal bone shaft, stained according to Masson. The thickness of the cortical plate was measured, and the numerical density, area, and diameter of osteons and Haversian canals were determined. Results. After 4 months of the experiment, compared with the control, a decrease in the proportion of mineralized structures of the cortical plate by 15% (p=0.0001) was revealed, its thickness was reduced by 12.7% (p=0.0184), signs of osteolysis were expressed in the osteon layer, numerical density of osteons was reduced, as well as their dimensional characteristics, osteons with dilated Haversian canals were noted. In the period of 6 months, the thickness of the cortical plate did not have significant differences from the norm (p=0.2067), however, a decrease in the proportion of mineralized structures progressed by 33.6% (p=0.0001). In the osteon layer, reduced values of the numerical density of osteons, their area and diameters remained. The diameters of Haversian canals of osteons increased over time. Conclusions. The developed experimental 2D model for assessing denervation osteopenia of the distal limb parts is applicable in further studies of rehabilitation effects that accelerate and improve reinnervation.

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