Letters to the EditorCHEMICAL IRRITATION OF NERVE-ROOT IN DISC PROLAPSE
References (4)
The Lumbar Disc
(1971)Orthop. Clin. N. Am.
(1971)
Cited by (91)
Selective intradural dorsal rhizotomy for persistent radicular leg pain: a contemporary series
2019, Spine JournalCitation Excerpt :Ongoing need for healthcare and delayed return to work lead to significant economic burden [24]. Explanations for persistent pain, despite adequate surgical decompression of the nerve root, vary from chemical inflammation of the nerve root due to inflammatory mediators from a ruptured intervertebral disc or annulus fibrosus to postoperative arachnoiditis and epidural fibrosis [2,10,15]. Furthermore, lumbar disc surgery is associated with a less favourable outcome when pain and radicular symptoms last preoperatively for 12 months or longer [17].
Percutaneous Treatment of Herniated Lumbar Discs with Ozone: Investigation of the Mechanisms of Action
2016, Journal of Vascular and Interventional RadiologyCitation Excerpt :Oxygen-ozone treatment appears to have an antiinflammatory mechanism of action in addition to its GAG-mediated reduction of disc volume. This finding is consistent with pathobiologic theories of herniated disc pain itself, which implicate chemical inflammatory factors as well as mechanical nerve root compression in the generation of radicular symptoms (38,39). Proinflammatory cytokines secreted following peripheral nerve trauma are now understood to play a crucial role in many kinds of neuropathic pain and may prolong the pain state even after mechanical pressure is relieved (40).
Possible role of autoimmune reaction in Modic Type I changes
2011, Medical HypothesesCitation Excerpt :The NP has generally been considered to be an immune-privileged tissue that is isolated from the immune system owing to its lack of access to the systemic circulation. Therefore, once the NP becomes in contact with the immune system, as with similar immune-privileged tissues, including the eye and testis, it is recognized as a foreign antigen and an inflammatory autoimmune response is mounted [17,42,43]. Repetitive loading after endplate damage appeared to cause buckling of the lamellae of the annulus: the inner lamellae can collapse inward while the outer lamellae can bulge outward.
Injection Procedures
2007, Interventional Spine E-Book: An Algorithmic ApproachPathology of lumbar nerve root compression Part 1: Intraradicular inflammatory changes induced by mechanical compression
2004, Journal of Orthopaedic ResearchThe efficacy of lumbar epidural steroid injections in patients with lumbar disc herniations
2007, Anesthesia and AnalgesiaCitation Excerpt :In some patients with lumbar disk herniations, conservative pharmacologic and/or physical therapy may not provide adequate pain relief and more aggressive therapies such as LESI may be helpful. An epidural injection can decrease inflammation in the epidural space and can decrease pain in the affected nerve root (11,12). Our study suggests that a TF approach offers benefit for increased analgesic efficacy when compared to the C or IL approach.