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2015, Número 1

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Revista Cubana de Ortopedia y Traumatología 2015; 29 (1)


Relación entre la degeneración discal, el dolor y la estabilidad lumbar: dolor

Tabares NH, Díaz QJM

Idioma: Español
Referencias bibliográficas: 45
Paginas: 74-87
Archivo PDF: 670.81 Kb.


RESUMEN

Introducción: el dolor lumbar clasifica como uno de los trastornos musculoesqueléticos más comunes, la degeneración del disco intervertebral es aceptada como la mayor causa de dicho dolor, el conocimiento de la fisiopatología de la degeneración del disco intervertebral y el dolor asociado a ella, representan una de las mayores prioridades de las investigaciones biomédicas.
Objetivo: revisar y discutir los mecanismos directos e indirectos, relativos a la degeneración, que pueden ser causa de dolor lumbar.
Métodos: se realizó una revisión acerca de los mecanismos a través de los cuales, la degeneración del disco intervertebral, puede producir dolor, analizando aquellos que por vía mecánica o anatómica actúan indirectamente; y los que, a través de cambios biológicos y bioquímicos, pueden producir dolor de forma directa.
Resultados: de forma indirecta, la degeneración discal puede producir dolor al afectar de manera anatómica y funcional estructuras cercanas que están inervadas, no está claro que la degeneración discal provoque inestabilidad. Al interior del disco patológico ocurren cambios biológicos y bioquímicos con liberación de mediadores de inflamación que llevan a la neoinervación discal y a dolor.
Conclusiones: el dolor como consecuencia de la degeneración discal, se produce por mecanismos directos e indirectos, no está demostrado que la degeneración del disco provoque inestabilidad. Al interior del disco ocurre crecimiento de nervios nociceptivos que explican el dolor directo discógeno.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Ito K, Creemers L. Mechanisms of intervertebral disk degeneration/Injury and Pain: A Review. Global Spine J. 2013 Jun;3(3):145-52. doi: 10.1055/s-0033-1347300

  2. Brayda-Bruno M, Tibiletti M, Ito K, Fairbank J, Galbusera F, Zerbi A, Roberts S. Advances in the diagnosis of degenerated lumbar discs and their possible clinical application. Eur Spine J 2013;23(3):315-23. doi: 10.1007/s00586-013-2960-9.

  3. Lotz JC, Fields AJ, Liebenberg EC. The Role of the Vertebral End Plate in Low Back Pain. Global Spine J. 2013 Jun;3(3):153-64. doi: 10.1055/s-0033-1347298.

  4. Hiyama A, Sakai D, Mochida J. Cell Signaling Pathways Related to Pain Receptors in the Degenerated Disk. Global Spine J. 2013 Jun;3(3):165-74. doi: 10.1055/s-0033- 1345036.

  5. Erwin WM. Biologically Based Therapy for the Intervertebral Disk: Who is the Patient? Global Spine J. 2013 Jun;3(3):193-200. doi: 10.1055/s-0033-1343074.

  6. Weiler C, Nerlich AG, Bachmeier BE, Boos N. Expression and distribution of tumor necrosis factor alpha in human lumbar intervertebral discs: a study in surgical specimen and autopsy controls. Spine. 2005;30:44-54.

  7. Micankova AB, Vohanka S, Jarkovsky J, Bednarik J. Prediction of long-term clinical outcome in patients with lumbar spinal stenosis. Eur Spine J. 2012;21(12):2611-9.

  8. Grob D. The Aging Spine. Eur Spine J. 2003; 12 (Suplem 2): S84-S85.

  9. Tabares Neyra H, Díaz Quesada J. Trasplante autólogo de células madre medulares al disco intervertebral. Reporte Preliminar. Disponible en CD: XX Congreso Internacional Cubano de Ortopedia y Traumatología 2009 (memorias).

  10. Davis PC, Wippold II FJ, Brunberg JA, Cornelius RS, De La Paz RL, Dormont D. ACR Appropriateness Criteria® on Low Back Pain. J Am Coll Radiol. 2009;6:401-7.

  11. Wang ZX, Hu YG. High-intensity zone (HIZ) of lumbar intervertebral disc on T2- weighted magnetic resonance images: spatial distribution, and correlation of distribution with low back pain (LBP). Eur Spine J. 2012;21(7):1311-5.

  12. Steurer J, Roner S, Gnannt R, HodlerJ. Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: a systematic literature review. BMC Musculoskeletal Disorders. 2011;12:175.

  13. Blankenbaker DG, Haughton VM, Rogers BP, MeyerandME, Fine JP. Axial rotation of the lumbar spinal motion segments correlated with concordant pain on discography: a preliminary study. AJR 2006;186:795-9.

  14. Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res. 1982;(165):110-123.

  15. Fujiwara A, LimTH, An HS. The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine. 2000;25:3036-44.

  16. Krismer M, Haid C, Ogon M, Behensky H, Wimmer C. Biomechanics of lumbar instability. Orthopade. 1997;26:516-20.

  17. Tanaka N, An HS, Lim TH, Fujiwara A, Jeon CH, Haughton VM. The relationship between disc degeneration and flexibility of the lumbar spine. Spine J. 2001;1:47-56.

  18. Kettler A, Rohlmann F, Ring C, Mack C,Wilke H-J. Do early stages of lumbar intervertebral disc degeneration really cause instability? Evaluation of an in vitro database. Eur Spine J. 2011;20:578-84.

  19. Mimura M, Panjabi MM, Oxland TR, Crisco JJ, Yamamoto I, Vasavada A. Disc degeneration affects the multidirectional flexibility of the lumbar spine. Spine. 1994;19:1371-80.

  20. Galbusera F, Schmidt H, Neidlinger-Wilke C, Gottschalk A, Wilke HJ. The mechanical response of the lumbar spine to different combinations of disc degenerative changes investigated using randomized poroelastic finite element models. Eur Spine J. 2011;20:563-71.

  21. Kong M, Morishita Y, He W, Miyazaki M, Zhang H, Wu G, Hymanson H, Wang J. Lumbar Segmental Mobility According to the Grade of the Disc, the Facet Joint, the Muscle, and the Ligament Pathology by Using Kinetic Magnetic Resonance Imaging. Spine. 2009;34(23):2537-44.

  22. Rohlmann A, Zander T, Schmidt H, Wilke HJ, Bergmann G. Analysis of the influence of disc degeneration on the mechanical behaviour of a lumbar motion segment using the finite element method. J Biomech. 2006;39:2484-90.

  23. Bisschop A, van Royen BJ, Mullender MG, Cornelis PLP, Idsart K, Timothy UJ, van der Veen AJ, van Diee¨n JH. Which factors prognosticate spinal instability following lumbar laminectomy? Eur Spine J. 2012;21(12):2640-8.

  24. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001;26:1873-8.

  25. Kalichman L, Hunter DJ. Lumbar facet joint osteoarthritis: a review. Semin Arthritis Rheum. 2007;37:69-80.

  26. Suri P, Miyakoshi A, Hunter DJ, et al. Does lumbar spinal degeneration begin with the anterior structures? A study of the observed epidemiology in a community-based population. BMC Musculoskelet Disord. 2011;12:202.

  27. Adams M, Bogduck N, Burton K. Nerves and blood supply to the lumbar spine. In: Adams M, Bogduck N, Burton K, editors. The biomechanics of back pain. Cap. 4.Edinburgh: Churchill Livingstone; 2006: p. 43-8.

  28. Bogduck N. Clinical Anatomy of the Lumbar Spine and Sacrum. Oxford, UK: Elsevier Health Sciences; 2005.

  29. García Cosamalon J, Fernández Fernández J, González Martínez E, Ibáñez Plágaro J, Robla Costales J. La inervación del disco intervertebral. Neurocirugía. 2013;24(3):121-9.

  30. Fagan AB, Sarvestani G, Moore RJ, Fraser RD, Vernon-Roberts B, Blumbergs PC. Innervation of anulus tears: an experimental animal study. Spine. 2010;35:1200-05.

  31. Wilke HJ, Neef P, Caimi M, Hoogland T, Claes LE. New in vivo measurements of pressures in the intervertebral disc in daily life. Spine. 1999;24:755-62.

  32. Johnson WEB, Caterson B, Eisenstein SM, Roberts S. Human intervertebral disc aggrecan inhibits endothelial cell adhesion and cell migration in vitro. Spine. 2005;30:1139-47.

  33. Johnson WEB, Caterson B, Eisenstein SM, Hynds DL, Snow DM, Roberts S. Human intervertebral disc aggrecan inhibits nerve growth in vitro. Arthritis Rheum. 2002;46:2658-64.

  34. Dimitroulias A, Tsonidis C, Natsis K, et al. An immunohistochemical study of mechanoreceptors in lumbar spine intervertebral discs. J Clin Neurosci. 2010;17:742- 45.

  35. Fagan A, Moore R, Vernon Roberts B, Blumbergs P, Fraser R. ISSLS prize winner: the innervation of the intervertebral disc: a quantitative analysis. Spine. 2003;28:2570-76.

  36. Cui Y, Yu J, Urban JP, Young DA. Differential gene expression profiling of metalloproteinases and their inhibitors: a comparison between bovine intervertebral disc nucleus pulposus cells and articular chondrocytes. Spine. 2010;35:1101-08.

  37. Roberts S, Caterson B, Menage J, Evans EH, Jaffray DC, Eisenstein SM. Matrix metalloproteinases and aggrecanase: their role in disorders of the human intervertebral disc. Spine. 2000;25:3005-13.

  38. Weiler C, Nerlich AG, Zipperer J, Bachmeier BE, Boos N. 2002 SSE Award Competition in Basic Science: expression of major matrix metalloproteinases is associated with intervertebral disc degradation and resorption. Eur Spine J. 2002; 11:308-20.

  39. Shinohara H. A study on lumbar disc lesion. Significance of histology of free nerve endings in lumbar discs. J Jpn Orthop Assoc. 1970;44:553-70.

  40. Yoshizawa H, O’Brien JP, Smith WT, Trumper M. The neuropathology of intervertebral discs removed for low-back pain. J Pathol. 1980;132:95-104.

  41. Bogduk N. Nerves of the lumbar spine. In: Jayson M editor. The lumbar spine and the back pain. London: Churchill Livingstone; 1999. p. 61-88.

  42. Freemont AJ. The cellular pathobiology of the degenerate intervertebral disc and discogenic back pain. Rheumatol (Oxford). 2009;48:5-10.

  43. Burke JG, Watson RW, McCormack D, Dowling FE, Walsh MG, Fitzpatrick JM. Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br. 2002;84:196-201.

  44. Le Maitre CL, Hoyland JA, Freemont AJ. Catabolic cytokine expression in degenerate and herniated human intervertebral discs: IL-1beta and TNFalpha expression profile. Arthritis Res Ther. 2007;9:R77.

  45. Kokubo Y, Uchida K, Kobayashi S, Yayama T, Sato R, Nakajima H. Herniated and spondylotic intervertebral disc of the human cervical spine: histological and inmunohistological findings in 500 bloc surgical samples. Laboratory investigation. J Neurosurg spine. 2008;9:285-95.




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