Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats

Lei HAN; Ping ZHAO; Xue HAN; Jie WEI; Fei WANG; Yi LI; Guang-jin GUO

doi:10.1007/s11655-021-3276-y

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Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats

Original Article | Updated：2022-06-27

- Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats
- Chinese Journal of Integrative Medicine Vol. 28, Issue 6, Pages: 518-530(2022)
- Affiliations：
  
  1.Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing (100142), China
  2.Department of Bone and Joint Imaging Diagnosis, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing (100102), China
- Author bio：
  
  Prof. ZHAO Ping, E-mail: kzzp@sina.com
- Funds：
- DOI：10.1007/s11655-021-3276-y
  CLC：
- Published：01 June 2022，
  
  Published Online：29 September 2021，
  
  Accepted：24 August 2019
Scan for full text
Lei HAN, Ping ZHAO, Xue HAN, et al. Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats. [J]. Chinese Journal of Integrative Medicine 28(6):518-530(2022)
DOI：

Lei HAN, Ping ZHAO, Xue HAN, et al. Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats. [J]. Chinese Journal of Integrative Medicine 28(6):518-530(2022) DOI： 10.1007/s11655-021-3276-y.

摘要

目的:

观察2种脊柱手法对自体髓核组织诱导的急性神经根炎症模型大鼠根性疼痛的干预效果

探讨其作用机制.

方法:

采用随机数字表法将108只雄性SD大鼠随机分为6组

包括空白组、假手术组、模型组、假手法组、松动手法组及调整手法组

每组18只. 其中空白组为无任何干预的正常对照; 假手术组只在相应椎节(L5-6)左侧做局部软组织切开; 模型组通过手术在特定椎节(L5-6)左侧椎间孔外口神经根处植入自体髓核组织

建立急性L5神经根炎模型; 假手法组对模型大鼠施行匀速旋转运动; 松动手法组对模型大鼠施行低速低幅旋转运动; 调整手法组对模型大鼠施行高速低幅旋转运动. 3种模拟手法分别于造模后1、3、5、8、10、12天进行干预

其余3组无任何特殊干预. 每组各取6只大鼠于术前1天及术后第1—7、10、12、14天进行一般行为学观察

测定50%机械性撤足痛阈值(PWT)和热辐射刺激缩爪反应潜伏期 (PWL). 另各取6只大鼠分别于术后第5和12天检测术侧L5背根神经节中一氧化氮合酶(NOS)的表达.

结果:

3组模拟手法干预后

调整手法组50%PWT和PWL在术后第6、7天时高于假手法组

第10、12、14天时更高(

0.05或

0.01)

而松动手法组在术后1—4天时高于调整手法组(

0.05或

0.01). 调整手法组和松动手法组NOS表达在术后第12天低于假手法组(

0.01).

结论:

在镇痛方面

调整手法、松动手法均能产生比假手法更好的效果

可能通过减少神经炎症发挥作用. 在治疗早期阶段

与调整手法比较

松动手法刺激反应更小. 脊柱手法可能抑制NOS过度表达

从而减轻神经根强烈的炎症刺激反应.

Abstract

Objective:

To compare the analgesic effects of two types of spinal manipulation (SM) in acute lumbar radiculopathy (ALR) model rats induced by self-transplantation of autologous nucleus pulposus (ANP)

and clarify the therapeutic mechanism.

Methods:

Totally 108 male Sprague-Dawley rats were randomly divided into 6 groups by a random number table (18 rats in each group)

including a blank group with no interference

a sham operation group with a surgery by making a local soft tissue incision on the left side of L5–6 vertebral segment

a model group with ALR of L5 extraforaminal nerve by ANP self-transplantation without other interference

a sham manipulation (SMA) group with simulating physical rotation

as well as a mobilization (MOB) group with simulating low-velocity and variable-amplitude rotation and a manipulation (MAN) group with simulating high-velocity and low-amplitude rotation. The interventions in SMA

MOB

and MAN groups started 1 day after modeling followed by another 5 treatments at days 3

10 and 12. Rats in the other 3 groups did not receive any special intervention. Behavioral pain tests of 50% mechanical pain withdrawal threshold (50% PWT) and paw withdrawal latency (PWL) were conducted 1 day before operation followed by another 10 tests on days 1–7

12 and 14. Immunohistochemical expression of nitric oxide synthase (NOS) was investigated on days 5 and 12 after operation.

Results:

After 3 experimental SM interventions

50% PWT and PWL were higher in the MAN group than the SMA group on days 6 and 7

and higher on days 10

12 and 14 postoperatively (

0.05 or

0.01)

while the same indices were significantly higher in the MOB group than MAN group on days 1–4 (

0.05 or

0.01). The expression of NOS was lower in the MAN and MOB groups than SMA group on day 12 postoperatively (

0.01).

Conclusions:

Both manipulation and mobilization produced better results than sham interference in relieving pain by reducing neuroinflammation possibly. At the early period

compared with manipulation

mobilization presented less sensitive response to pain until later visit. SM may inhibit the overexpression of NOS

thereby alleviating severe radiculopathy.

关键词

Keywords

spinal manipulationradiculopathyanti-inflammationanalgesia

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