Self reported health status and magnetic resonance imaging findings in patients with low back pain

Hollingworth, William; Dixon, A K; Todd, Chris; Bell, MI; Antoun, N.M.; Arafat, Q W; Girling, Simon J.; Karia, KR; Laing, RJ

doi:10.1007/s005860050092

Cited by 41 publications

(24 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinically, mechanical compression of the lumbar spinal nerve roots, either by disc prolapse or spinal stenosis, is a common mechanism of painful lumbar radiculopathy [7,27,35]. Though the symptoms and physical sign are clear in clinic, but the pathophysiology of the back pain and radiculopathy associated with lumbar stenosis and lumbar disc herniations is incompletely understood.…”

Section: Introductionmentioning

confidence: 99%

A rat model for chronic spinal nerve root compression

et al. 2013

View full text Add to dashboard Cite

Objectives The pathophysiology of radiculopathy associated with lumbar spinal stenosis and lumbar disc herniation is incompletely understood. The goal of the present study was to establish a chronic spinal nerve root compression model that can mimic lumbar disc herniation or spinal stenosis using silicone tube compression. We also try to link the pathology changes of damaged nerve root with the reaction of microglia in spinal cord in same rat at different time points. Methods Thirty rats were used in this study. The L5 nerve roots (dorsal and ventral) were exposed by hemilaminectomy; the diameter of the L5 nerve root was measured at the 2 mm proximal from the dorsal root ganglia. The dorsal and ventral nerve roots of L5 were compressed using a silicone tube, and the sham group was only exposed dorsal and ventral roots of L5. Five rats from the sham group were perfused at 8 days after surgery, and 25 rats from the model groups were perfused at 3, 8, 12, 45 days, and 5 months after surgery, each model group was composed of 5 rats according to the time point. The L5 spinal cord segments and nerve root that compressed by silicone tube were harvested from the same rat. Microglia and neuron in the spinal cord were stained by immunohistochemistry, and the nerve root was shown by electron microscope. Results In sham-operated rat, the arrangement of axon and myelin sheath is normal, the ventral root is mainly composed of large axon ([6 lm) and it is composed of 46.3 % of all the axons of the ventral root; the average myelin thickness of large axon is 1.86 lm; the dorsal root is mainly composed of medium (2-3.9 or 4-5.9 lm) axons and they are composed of 79.1 % of all the axons of the dorsal root; the average myelin thickness of this category is 0.94 or 1.55 lm. The average myelin thickness of large axon in ventral root reduced to 0.97 and 1.19 lm from more than 1.86 lm after compression for 3 and 8 days separately. Most of myelin sheath disappeared after 12 days of compression; the myelin sheath was partly restored at 45 days after compression which the myelin sheath thickness of large axons in ventral root was 0.47 lm. The medium category in dorsal root reduced to 0.59 or 0.72 lm from 0.94 lm, and 1.55 lm after compression for 3 days (p \ 0.05 to p \ 0.0001). The medium category axon in dorsal root is also 0.47 lm after compression for 45 days (p B 0.0001). The myelin sheath was almost totally restored at the 5 months of compression; the myelin sheath thickness returned to normal and the axons were intact in structure under EM. The number of Iba1-positive microglia increased by 18.69, 40.44, and 18.49 % after compression for 3, 8, and 12 days separately in the ipsilateral dorsal horn and 21.26, 32.15, 22.87 % in ventral horns, and the activation of microglia was also prominent in contralateral sides of the dorsal and ventral horn at

show abstract

Section: Introductionmentioning

confidence: 99%

A rat model for chronic spinal nerve root compression

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Painful lumbar radiculopathy (LR) commonly results from mechanical compression of lumbar nerve roots, either by disc prolapse or spinal stenosis [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Mechanical Thresholds for Initiation and Persistence of Pain Following Nerve Root Injury: Mechanical and Chemical Contributions at Injury

Winkelstein

DeLeo

2004

Journal of Biomechanical Engineering

View full text Add to dashboard Cite

There is much evidence supporting the hypothesis that magnitude of nerve root mechanical injury affects the nature of the physiological responses which can contribute to pain in lumbar radiculopathy. Specifically, injury magnitude has been shown to modulate behavioral hypersensitivity responses in animal models of radiculopathy. However, no study has determined the mechanical deformation thresholds for initiation and maintenance of the behavioral sensitivity in these models. Therefore, it was the purpose of this study to quantify the effects of mechanical and chemical contributions at injury on behavioral outcomes and to determine mechanical thresholds for pain onset and persistence. Male Holtzman rats received either a silk or chromic gut ligation of the L5 nerve roots, a sham exposure of the nerve roots, or a chromic exposure in which no mechanical deformation was applied but chromic gut material was placed on the roots. Using image analysis, nerve root radial strains were estimated at the time of injury. Behavioral hypersensitivity was assessed by measuring mechanical allodynia continuously throughout the study. Chromic gut ligations produced allodynia responses for nerve root strains at two-thirds of the magnitudes of those strains which produced the corresponding behaviors for silk ligation. Thresholds for nerve root compression producing the onset (8.4%) and persistence of pain (17.4-22.2%) were determined for silk ligation in this lumbar radiculopathy model. Such mechanical thresholds for behavioral sensitivity in a painful radiculopathy model begin to provide biomechanical data which may have utility in broader experimental and computational models for relating injury biomechanics and physiologic responses of pain. ABSTRACTThere is much evidence supporting the hypothesis that magnitude of nerve root mechanical injury affects the nature of the physiological responses which can contribute to pain in lumbar radiculopathy. Specifically, injury magnitude has been shown to modulate behavioral hypersensitivity responses in animal models of radiculopathy.However, no study has determined the mechanical deformation thresholds for initiation and maintenance of the behavioral sensitivity in these models. Therefore, it was the purpose of this study to quantify the effects of mechanical and chemical contributions at injury on behavioral outcomes and to determine mechanical thresholds for pain onset and persistence. Male Holtzman rats received either a silk or chromic gut ligation of the L5 nerve roots, a sham exposure of the nerve roots, or a chromic exposure in which no mechanical deformation was applied but chromic gut material was placed on the roots.Using image analysis, nerve root radial strains were estimated at the time of injury.Behavioral hypersensitivity was assessed by measuring mechanical allodynia continuously throughout the study. Chromic gut ligations produced allodynia responses for nerve root strains at two-thirds of the magnitudes of those strains which produced the corresponding behaviors f...

show abstract

“…It has been shown that patients complaining of numbness have a higher probability of medullary signal alteration on MR imaging [25]. The selection of patients with higher scores for sleeping and numbness would probably decrease the number of negative MR examinations [8].…”

Section: Discussionmentioning

confidence: 99%