颈后路臂丛神经根性撕脱诱发神经病理性疼痛模型建立的初步研究  

A preliminary study on the establishment of a neuropathic pain model induced by brachial plexus root avulsion in posterior cervical approach

作　　者：王立[1] 翟旭 宋晓亮 段文旭[1] 王丰羽 吕莉[1] 邵新中[1] 张哲敏[1] 许娅莉[1] Wang Li;Zhai Xu;Song Xiaoliang;Duan Wenxu;Wang Fengyu;Lv Li;Shao Xinzhong;Zhang Zhemin;Xu Yali(Department of Hand Surgery,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院手外科,石家庄050051

出　　处：《中华手外科杂志》2021年第6期474-477,共4页Chinese Journal of Hand Surgery

摘　　要：目的建立一种新的可靠的颈后路臂丛神经根性撕脱伤诱发神经病理性痛的大鼠模型。方法将40只大鼠随机分为2组:颈后路组20只,假手术组20只。颈后路组于颈椎后路行部分椎板切除+颈5、颈6神经根性撕脱术;假手术组仅行部分椎板切除并暴露颈5、颈6神经根。术前和术后检测大鼠患侧肢体机械刺激痛阈值、冷刺激痛阈值。术后第31天,取大鼠颈髓损伤节段进行免疫组织化学检验,统计分析数据。结果颈后路组大鼠患肢机械诱发痛阈值于术后第1天开始升高并趋于稳定,术后第19天开始下降,并于术后第22天开始出现阳性表现(P<0.01);冷刺激诱发痛于术后第22天开始出现阳性表现(P<0.01);免疫组织化学检验结果:术后第31天,颈后路组大鼠脊髓损伤节段星形胶质细胞激活标志物(GFAP)和小胶质细胞的激活标志物(Iba1)数量明显高于假手术组(P<0.01)。结论颈后路臂丛颈5、颈6神经根性撕脱伤模型可以模拟典型的神经病理性疼痛,是一种较为理想的研究臂丛根性撕脱伤诱发神经病理性痛的动物模型。Objective To establish a new and reliable rat model of neuropathic pain induced by brachial plexus roots avulsion through posterior cervical approach.Methods Forty rats were randomly divided into two groups:20 in the posterior cervical approach group(PCA)and 20 in the sham surgery group(Sham).The PCA group were underwent partial laminectomy,and C5 to C6 nerve roots were avulsed through the posterior cervical approach;the Sham group were only underwent partial laminectomy and expose the C5 to C6 nerve roots.The pain threshold of mechanical stimulation and cold stimulation of the affected limb were measured before and after surgery.On the 31st day after operation,the injured segments of rat cervical spinal cord were taken for immunohistochemical test,and the data were analyzed statistically.Results In the PCA group,the pain threshold of mechanical stimulation of the affected limb began to increase and stabilized on the first day after operation,then began to decrease on the 19th day after operation,and positive symptoms appeared on the 22nd day after operation(P<0.01).The pain threshold of cold stimulation began to show positive symptoms on the 22nd day after operation(P<0.01).The immunohistochemical test results showed that the number of astrocyte activation markers(GFAP)and microglial activation markers(Iba1)in the injured spinal cord segments of the rats in the PCA group were significantly higher than that in the Sham group(P<0.01).Conclusion The rat model of C5 to C6 nerve root avulsion through posterior cervical approach can induce typical neuropathic pain.This is an ideal animal model for studying neuropathic pain induced by brachial plexus root avulsion.

关 键 词：臂丛 动物实验 神经病理性疼痛 部分椎板切除 

分 类 号：R-332[医药卫生] R688