颈椎小关节源性疼痛机制的神经生物学研究进展  

Advances in neurobiological mechanism of cervical facet joint pain

作　　者：唐峰[1] 谢宁[1] 

机构地区：[1]第二军医大学附属长征医院脊柱外科,上海200003

出　　处：《中国骨科临床与基础研究杂志》2015年第5期298-304,共7页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：颈椎小关节疾病是颈部慢性疼痛的常见来源,临床上较为关注其诊断的精确性和稳定性,而对病理生理及疼痛机制,特别是相关神经生物学研究缺乏足够的认识。该文从疼痛产生的细胞学水平层面对颈椎小关节源性疼痛这一由多种炎性因子及神经递质参与调节及维持的综合反应进行综述:介绍颈椎小关节神经支配及其疼痛感受器的分布情况,阐述慢性损伤后小关节发生的不可逆的神经病理变化(包括神经元激活、炎性因子释放和神经元免疫表型改变等),并重点介绍其中参与疼痛启动与维持的疼痛传入递质、应激相关蛋白和局部炎性因子、脊髓谷氨酸等三大类神经递质和肽类。Diseases of cervical facet joint is a common source of chronic neck pain. Clinically, the accuracy and stability of the diagnosis of cervical facet joint-induced pain is often been concerned, whereas the pathophysiology and pain mechanism, especially the related neurobiological information were still not recognized adequately. In this paper, researches in pain from cervical facet joint, which is a integrated reaction regulated and maintained by all kinds of inflammatory factors and neurotransmitters, were reviewed from the aspect of cytological level of pain induction： the innervation and the distribution of pain receptors of cervical facet joint were introduced, irreversible neuropathological changes of cervical facet joint after chronic injuries were discussed which involved neuron activation, inflammatory cytokines release and changes of neuronal phenotype,at the same time, neurotransmitters and peptides involved in starting and sustaining the facet joint pain were emphasized which including the following three categories： pain neurotransmitters, stress-related proteins and local inflammatory factors, as well as spinal glutamate.

关 键 词：颈椎 关节疾病 疼痛 神经生物学 疼痛感受器 神经递质 细胞因子类 神经肽类 

分 类 号：R681.55[医药卫生—骨科学]