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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 12, 1666-1672.
doi: 10.1302/0301-620X.89B12.19258  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The effects of the sympathetic nerves on lumbar radicular pain

A BEHAVIOURAL AND IMMUNOHISTOCHEMICAL STUDY

S. Mizuno, MD, Orthopaedic Surgeon1; T. Takebayashi, MD, PhD, Assistant Professor1; T. Kirita, MD, PhD, Orthopaedic Surgeon1; K. Tanimoto, MD, Orthopaedic Surgeon1; N. Tohse, MD, PhD, Professor and Chairman2; and T. Yamashita, MD, PhD, Professor and Chairman1

1 Department of Orthopaedic Surgery
2 Department of Cellular Physiology and Signal Transduction School of Medicine Sapporo Medical University, South 1, West 16 & 17, Chuo-ku, Sapporo 060–8543, Japan.

Correspondence should be sent to Dr S. Mizuno; e-mail: smizuno{at}sapmed.ac.jp

A rat model of lumbar root constriction with an additional sympathectomy in some animals was used to assess whether the sympathetic nerves influenced radicular pain. Behavioural tests were undertaken before and after the operation.

On the 28th post-operative day, both dorsal root ganglia and the spinal roots of L4 and L5 were removed, frozen and sectioned on a cryostat (8 µm to 10 µm). Immunostaining was then performed with antibodies to tyrosine hydroxylase (TH) according to the Avidin Biotin Complex method. In order to quantify the presence of sympathetic nerve fibres, we counted TH-immunoreactive fibres in the dorsal root ganglia using a light microscope equipped with a micrometer graticule (10 x 10 squares, 500 mm x 500 mm). We counted the squares of the graticule which contained TH-immunoreactive fibres for each of five randomly-selected sections of the dorsal root ganglia.

The root constriction group showed mechanical allodynia and thermal hyperalgesia. In this group, TH-immunoreactive fibres were abundant in the ipsilateral dorsal root ganglia at L5 and L4 compared with the opposite side. In the sympathectomy group, mechanical hypersensitivity was attenuated significantly.

We consider that the sympathetic nervous system plays an important role in the generation of radicular pain.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General