神经移植术修复幼年大鼠臂丛神经损伤后对神经元保护作用的实验研究

目的研究神经移植术修复幼年大鼠臂丛神经损伤后对神经元的保护作用。方法将出生18 d SD大鼠24只等分为2组。神经根切断组：将右侧颈，神经根切除0．3cm。神经根修复组：颈5神经根部分切除后取腓肠神经移植修复。采用True Blue注射法逆行标记神经元。于术后4周取颈，脊髓和背根神经节，应用TUN-EL法检测运动及感觉神经元中细胞凋亡情况，并观察两组神经元数量的变化。结果与神经根切断组相比，神经根修复组神经元数量显著增加（P〈0．01），凋亡细胞数明显减少（P〈0．01）。结论神经移植术修复幼年大鼠臂丛神经损伤后对近端运动和感觉神经元有保护作用。     

兔颈部硬脊膜表面及椎板旁神经分布的实验研究

目的：观测兔颈部硬脊膜表面及椎板旁的神经分布规律,为颈性眩晕发病机理的研究提供实验依据.方法：20只新西兰兔,分为硬脊膜实验组及对照组、椎板旁实验侧及对照侧,分别于实验组（侧）（C6硬脊膜或C5椎板表面）喷涂辣根过氧化物酶（HRP）溶液、而对照组（侧）喷涂生理盐水,48h后切取双侧颈上神经节、颈下神经节（或星状神经节）及双侧脊神经节,按TMB法进行成色反应,光镜观察HRP标记细胞形态及其分布情况.利用辣根过氧化物酶逆行示踪技术,了解硬脊膜表面及椎板旁的神经分布规律.结果：硬脊膜实验组双侧C5～C7脊神经节内出现HRP标记细胞,椎板旁实验侧同侧C4～C6脊神经节内出现HRP标记细胞,交感神经节及对照组（侧）脊神经节内未出现标记细胞.结论：颈部硬脊膜表面的神经主要来自双侧脊神经节,相邻节段间有重叠分布;椎板旁的神经主要来自同侧脊神经节,且相邻节段间有重叠.     

幼年大鼠神经根移植修复对GDNF及其受体影响的研究

目的 研究神经移植术修复幼年大鼠臂丛神经损伤后对神经元胶质细胞源性神经营养因子(GDNF)及其受体GFRα1的影响.方法 将出生18 d SD大鼠12只等分为2组:颈5切断组,将右侧颈5神经根切除0.3 cm;颈5修复组,颈5神经根切除后取腓肠神经移植修复.于术后4周取颈5脊髓和背根神经节,行免疫组织化学染色检测脊髓前角和背根神经节及免疫阳性颗粒的数量.并比较两组间的差异.结果 颈5修复组运动和感觉神经元GDNF免疫阳性颗粒数目分别为(786.3±176.84)和(2997.0±357.99)个,颈5切断组运动和感觉神经元阳性颗粒数目分别为(335.0±49.50)和(1632.0±305.55)个,两组差异有统计学意义(P<0.01 ).颈5修复组运动和感觉神经元GFRα1免疫阳性颗粒数目分别(787.5±178.55)和(3111.0±445.72)个,颈5切断组运动和感觉神经元阳性颗粒数目分别为(397.3±41.78)和(1588.3±229.00)个,两组差异有统计学意义(P<0.01).结论 神经移植术修复幼年大鼠臂丛神经损伤后对近端神经元的保护作用与GDNF及其受体GFRα1增多有关.     

颈7神经不同平面切断对神经元影响的实验研究

目的 研究颈7神经不同平面切断及不同时期对神经元逆行性退变的影响,为临床选择合适的时间和方法保护受损神经元提供实验依据.方法 36只SD雌性大鼠随机分为三组:对照组、神经根部切断组和神经支部切断组.利用True Blue逆行示踪技术对各组大鼠背根神经节感觉神经元和脊髓前角运动神经元精确计数,并利用神经元特异性烯醇化酶(neuron specific enolase,NSE)免疫荧光双标技术检验标记神经元的活性.结果 术后1周,神经根部切断组和神经支部切断组较对照组无明显的感觉和运动神经元数量变化.术后16周,神经根部切断组和神经支部切断组较对照组感觉和运动神经元减少,其中神经根部切断组较神经支部切断组减少更明显(P＜0.05).且各组True Blue标记神经元全部被NSE免疫荧光双标.结论 颈7神经根部切断和神经支部切断均发生感觉和运动神经元逆行性退变,且不同平面切断对神经元退变的影响有显著性差异.提示臂丛神经根性损伤后早期修复受损神经有利于防止神经元退变.     

神经轴突二次损伤对健侧颈7神经根移位术疗效影响的实验研究

目的以大鼠健侧颈，神经根移位术为动物模型，比较健侧颈7神经根移位术后神经轴突一次和二次损伤对中枢神经元及周围神经的影响差异。方法清洁级雌性SD大鼠60只，随机分成3组。A组为健侧颈，神经根移位术二次完成组；B组为健侧颈7神经根移位术一次完成组；C组为正常对照组。术后通过脊髓神经元计数、肌电图检查、神经肌肉组织学检查、肌张力测定和运动终板形态学检查进行综合评价。结果健侧颈，神经根移位术后36周，脊髓前角α运动神经元和背根神经节感觉元的数目A组较B组减少。但A组的再生神经纤维数目增加，而肌电图检查潜伏期延长。2组间肌张力、肌湿重、肌纤维截面积等无明显差异。结论神经轴突二次损伤，可减少中枢神经元数目，但再生神经纤维增加，最终对肌肉形态与肌张力的恢复无明显影响。     

幼年大鼠神经根断裂后移植修复对神经元凋亡基因表达影响的研究

目的 观察幼年大鼠神经根损伤后即行神经移植修复对近端神经元C-Jun和Bcl-2表达水平的影响.方法 将出生18 d SD大鼠24只等分为2组:神经根切断组,将右侧颈5神经根切除0.3cm;神经根修复组,颈5 神经根切除后取腓肠神经移植修复.于术后4周取颈5脊髓和背根神经节.通过RT-PCR检测大鼠近端神经元C-Jun和Bcl-2 mRNA的表达水平,并比较两组间的差异.结果 与神经根切断组相比,神经根修复组神经元C-Jun mRNA的表达水平明显下降,Bcl-2 mRNA 的表达水平显著升高.结论 幼年大鼠凋亡基因表达水平变化是产瘫早期臂丛神经修复手术保护近端神经元的分子机制.     

幼年大鼠神经根断裂后移植修复对神经元凋亡基因表达影响的研究

目的 观察幼年大鼠神经根损伤后即行神经移植修复对近端神经元C-Jun和Bcl-2表达水平的影响.方法 将出生18 d SD大鼠24只等分为2组:神经根切断组,将右侧颈5神经根切除0.3cm;神经根修复组,颈5 神经根切除后取腓肠神经移植修复.于术后4周取颈5脊髓和背根神经节.通过RT-PCR检测大鼠近端神经元C-Jun和Bcl-2 mRNA的表达水平,并比较两组间的差异.结果 与神经根切断组相比,神经根修复组神经元C-Jun mRNA的表达水平明显下降,Bcl-2 mRNA 的表达水平显著升高.结论 幼年大鼠凋亡基因表达水平变化是产瘫早期臂丛神经修复手术保护近端神经元的分子机制.     

幼年大鼠神经根断裂后移植修复对神经元凋亡基因表达影响的研究

目的 观察幼年大鼠神经根损伤后即行神经移植修复对近端神经元C-Jun和Bcl-2表达水平的影响.方法 将出生18 d SD大鼠24只等分为2组:神经根切断组,将右侧颈5神经根切除0.3cm;神经根修复组,颈5 神经根切除后取腓肠神经移植修复.于术后4周取颈5脊髓和背根神经节.通过RT-PCR检测大鼠近端神经元C-Jun和Bcl-2 mRNA的表达水平,并比较两组间的差异.结果 与神经根切断组相比,神经根修复组神经元C-Jun mRNA的表达水平明显下降,Bcl-2 mRNA 的表达水平显著升高.结论 幼年大鼠凋亡基因表达水平变化是产瘫早期臂丛神经修复手术保护近端神经元的分子机制.     

大鼠胸背神经和背阔肌在脊髓节段及脊神经节的定位研究

目的探讨胸背神经和背阔肌在脊髓及脊神经节的定位,为临床作同侧C_7神经根移位修复臂丛上干损伤提供理论依据。方法选用SD大鼠20只,随机分成2组。一组在胸背神经内注入30％HRP,另一组在背阔肌内注入30％HRP。术后48h经升主动脉灌注处死,取双侧C_4～T_2脊髓节段和脊神经节,冰冻切片后利用TMB法进行呈色反应,观察切片内HRP标记细胞的情况。结果胸背神经和背阔肌注射HRP后,在脊髓可见标记的运动神经元胞体分布在同侧C_6～C_8前角,主要分布在C_7、C_8。两组C_7的HRP标记细胞数分别为[(19．60±2．61)个,x±s,下同]和(10．90±1．27)个,C_8的HRP标记细胞数分别为(21．30±3．24)个和(11．80±1．66)个。感觉神经纤维来自于同侧C_6～C_8脊神经节,各神经节的HRP标记细胞数量相近(P>0．05)。结论背阔肌主要由C_7、C_8神经根支配,胸背神经的运动纤维主要来自C_7和C_8脊髓节段,因而临床开展同侧C_7神经根移位修复臂丛神经上干损伤从理论上是可行的。     

幼年大鼠神经根不同时间移植修复对神经元的影响

目的 研究不同时间神经移植术修复幼年大鼠臂丛损伤后对近端神经元的影响. 方法 从2009年1月至12月,将出生18 dSD大鼠48只随机等分为8组:第5颈神经(简称颈5)切断组、立即修复组及3、6、9、12、15、18d修复组.采用True blue注射法逆行标记神经元.颈5切断组将右侧颈5神经根切除0.3 cm;立即修复组将颈5神经根切除后取腓肠神经行移植修复.其余各组分别在颈5切断后间隔相应时间修复.术后4周,取颈5脊髓前角和背根神经节,比较各组神经元存活数量的差异.结果 幼年大鼠颈5切断后,3、6d修复组与立即修复组近端神经元计数结果的差异无统计学意义(均为P＞0.05),上述三组神经元数量较颈5切断组显著增多(P＜0.05).与立即修复组相比,9d修复组近端感觉神经元数量明显减少(P＜0.05),但运动神经元数量差异无统计学意义(P＞0.05).颈5切断组和15、18d修复组近端神经元数量的差异无统计学意义(P＞0.05). 结论 幼年大鼠神经根损伤后,在0～9d(相当于人类0～6个月)内修复对近端神经元可产生较满意的保护作用.这提示临床上对有手术指征的产瘫应争取在出生后6个月内手术.     

Dorsal root ganglionectomy for pseudotumor of the L3 dorsal root ganglion: a rare case and a rare treatment

Dorsal root ganglia are oval enlargements on the dorsal nerve roots and contain the cell bodies of sensory neurons. Asymmetry of dorsal root ganglia may occur naturally, yet natural occurrence of gigantic dorsal root ganglion (DRG) is rare. The patient was 61-year-old woman who presented with atypical symptoms like neuropathic pain and urinary distention. Neuroimaging has shown left L3-4 far-lateral disc herniation and a gigantic L3 DRG. At surgery, the dural sheath of the ganglion had to be opened and a firm, yellow-colored abnormal tissue was exposed. The abnormal tissue considered to be a tumor of neural origin was gross totally excised and the patient’s symptoms ceased immediately after surgery. Histopathological examination of the specimen revealed nothing more than normal DRG morphology. At 4 months postoperatively, the patient is well with mild L3 hyperesthesia and hyperalgesia. Dural sheath opening in neurosurgery is not a routine practice. The sheath may need to be opened when surgeon suspects of a tumor, a free disc fragment and any inflammation within the ganglion. Operative morphology of a severely edematous but non-tumoral (pseudotumor) ganglion has not previously been documented.

     

Comparison of neuropathic pain and neuronal apoptosis following nerve root or spinal nerve compression

Altered dorsal root ganglion (DRG) function is associated with neuropathic pain following spinal nerve injury. However, compression of the cauda equina and dorsal rhizotomy proximal to the DRG do not induce significant pain, whereas in the spinal nerve and peripheral nerve, injury distal to the DRG does induce neuropathic pain. Caspase signaling induces apoptosis, and caspase inhibitors prevent pain-related behavior. The degree of DRG neuronal apoptosis is thought to play a role in pain behavior. We suggest that differences in pain behavior according to the injury sites within the DRG may be related to imbalances in apoptotic injuries. The aim of this study was to determine which compression injury was more painful and to compare behavior with expression of tumor necrosis factor (TNF)-alpha in DRG and apoptosis in the DRG following crush injury to the L5 nerve root or L5 spinal nerve. Sprague–Dawley rats received a crush injury to the L5 spinal nerve (distal to the DRG), crush injury to the L5 nerve root (proximal to the DRG), or no crush injury (sham). Mechanical allodynia was determined by the von Frey test. Expression of TNF-alpha was compared among three groups using immunoblot findings. Furthermore, we compared the percentage of neurons injured in the DRG using immunostaining for apoptotic cells and localization of activated caspase 3. Mechanical allodynia was observed in both crush injury groups. The duration of mechanical allodynia in the distal crush group was significantly longer than in the proximal crush group (P < 0.05). TNF-alpha expression was increased in DRG neurons following injury. DRG apoptosis in the distal crush group was significantly higher than in the proximal group at each time point (P < 0.05). This study suggests that spinal nerve crush injuries produce a greater degree of DRG apoptosis than do corresponding nerve root crush injuries, and that the former injuries are associated with longer lasting mechanical allodynia. Thus, differences in the time course of mechanical allodynia might be associated with an imbalance in DRG apoptosis.     

Herniated lumbar disc material as a source of free glutamate available to affect pain signals through the dorsal root ganglion

STUDY DESIGN: Combined prospective human cohort and prospective controlled animal model. OBJECTIVES: To determine whether free glutamate is available in herniated disc material in concentrations sufficient to diffuse to glutamate receptors and affect the activity of neurons in the dorsal root ganglion that may transmit pain information. SUMMARY OF BACKGROUND DATA: The severity of lumbar radicular pain cannot be fully explained by physical pressure on nerve roots or ganglions. In experimental models, inflammatory processes are relatively modest under conditions of disc herniation. The hypothesis for the current study was that the proteoglycan link and core proteins, which contain high fractions of acidic amino acids, may be a source of glutamate when enzymatically degraded in an environment without glutamate reuptake systems. Glutamate would be free to diffuse to the dorsal root ganglion to affect glutamate receptors. METHODS: Disc material was harvested during surgery from herniated and nonherniated portions in patients undergoing elective lumbar disc surgery and subjected to immunohistochemistry and high-performance liquid chromatography for assessment of the presence of extracellular disc matrix glutamate. Miniosmotic pumps with differing concentrations of radiolabeled glutamate based on human data were implanted in the rat epidural space for 72 hours and dorsal root ganglion (DRG) in the region were harvested. RESULTS: Densitometry of disc matrix demonstrated immunohistochemical evidence for significant extracellular glutamate (P < 0.002). High performance liquid chromatography showed significant concentrations of glutamate in disc material and significantly more in herniated than in nonherniated disc material (P < 0.05). Significant radiolabeling of the dorsal root ganglion after epidural glutamate infusion was found at concentrations two orders of magnitude below measured disc glutamate levels. Autoradiography demonstrated radiolabeling of adjacent DRG. CONCLUSIONS: Glutamate originating from degenerated disc proteoglycan may diffuse to the dorsal root ganglion and effect glutamate receptors. Consideration may be given to treating disc radiculopathy with epidural glutamate receptor antagonists.     

Drug sensitivities of the primary afferents and their changes after inflammation

This study explored the possibility that altered sensitivities of the dorsal root and dorsal root ganglion to neuroactive substances released in inflamed tissue may be involved in radicular pain. The chemical sensitivities of the dorsal root and ganglion of rats were examined by monitoring nerve membrane potential. Endogenous pain inducing substances such as bradykinin, serotonin, acetylcholine, and histamine caused depolarizations of the dorsal root and the ganglion. Application of bradykinin or capsaicin to the dorsal root and ganglion on the isolated spinal cord preparation evoked spinal reflex activities in the lumbar ventral root. These results suggest that, when pain inducing substances are released at the dorsal root or its ganglion, they may initiate action potentials and cause pain. As an inflammation model, chromic gut was tied loosely around the lower lumbar nerve root. The dorsal root of the surgically treated rats showed an increased sensitivity to bradykinin when compared with sham operated rats. In contrast, the sensitivity of the dorsal root to gamma-aminobutyric acid, a major inhibitory transmitter in the spinal cord, was decreased. This result suggests that these reciprocal changes in the sensitivities of the dorsal root may play an important role in the pathogenesis of chemical radiculitis.     

Dorsal root ganglionectomy for the diagnosis of sensory neuropathies. Surgical technique and results

BACKGROUND: Inflammatory diseases stand out among sensory neuronopathies because, in their active phase, they can be treated with immunosuppressive agents. Immunosuppressive therapy may present severe adverse effects and requires previous inflammatory activity confirmation. Sensory neuronopathies are diagnosed based on clinical and EMG findings. Diagnostic confirmation and identification of inflammatory activity are based on sensory ganglion histopathological examination. We describe the surgical technique used for dorsal root ganglionectomy in patients with clinical/EMG diagnosis of sensory neuronopathies. METHODS: The sensory ganglion was obtained from 15 patients through a small T7-T8 hemilaminectomy and foraminotomy to expose the C7 root from its origin to the spinal nerve bifurcation. In 6 patients, the dural cuff supposed to contain the ganglion was resected en bloc; and in 9 patients, the ganglion was obtained through a longitudinal incision of the dural cuff and microsurgical dissection from the ventral and dorsal roots and radicular arteries. All ganglia were histopathologically examined. RESULTS: No ganglion was found in the dural cuff in 2 patients submitted to en bloc removal, and the ganglion was removed in all patients who underwent microsurgical dissection. All but 2 patients that had ganglion examination presented a neuronopathy of nerve cell loss, 3 with mononuclear inflammatory infiltrate. These patients underwent immunosuppressive therapy, and 2 of them presented clinical improvement. No surgical complications were observed. CONCLUSIONS: Microsurgical dorsal root ganglionectomy for diagnosing inflammatory sensory ganglionopathies was effective and safe. Although safe, en bloc resection of the proximal dural cuff was not effective for this purpose.     

A Rat Model of Radicular Pain Induced by Chronic Compression of Lumbar Dorsal Root Ganglion with SURGIFLO (TM)

Background: Radicular pain is a common and debilitating clinical pain condition. To date, the mechanisms of radicular pain remain unclear, partly because of the lack of suitable preclinical models. The authors report a modified rat model of radicular pain that could mimic a subset of clinical radicular pain conditions induced by the soft tissue compression on dorsal root ganglion.

Methods: A rat model of radicular pain was produced by infiltrating the L5 intervertebral foramen with 60 [mu]l of a hemostatic matrix (SURGIFLO (TM); Johnson & Johnson, Somerville, NJ) resulting in chronic compression of lumbar dorsal root ganglion. Thermal hyperalgesia and mechanical allodynia were measured with or without epidural treatment with triamcinolone. Western blot was used to assess the expression of the NR1 subunit of the N-methyl-d-aspartate receptor and inhibitory factor [kappa][beta]-[alpha], an inflammatory marker, within the affected L5 dorsal root ganglion and spinal cord dorsal horn.

Results: Chronic compression of lumbar dorsal root ganglion resulted in: (1) persistent mechanical allodynia and thermal hyperalgesia up to 4 or 5 postoperative weeks and (2) up-regulation of the N-methyl-d-aspartate receptor and inhibitory factor [kappa][beta]-[alpha] within the ipsilateral L5 dorsal root ganglion and spinal cord dorsal horn. Epidural administration of triamcinolone (6.25-100 [mu]g) on postoperative day 3 dose-dependently attenuated both thermal hyperalgesia and mechanical allodynia in rats with chronic compression of lumbar dorsal root ganglion.     

Pain and the spine. A review. 1. On the pathophysiology of radicular pain syndromes. Current concepts explaining pain in nerve entrapment syndromes

The problems of nociception and the development of pain in radicular syndromes of the spine may be summarized as follows: 1. The anatomic complex nerve root/dorsal ganglion is a key structure in the pain physiology of disk prolapse and spinal stenosis. 2. Chronic compression of nerve tissue causes structural changes. 3. These structural changes are associated with a change in the electrical properties of the nerve root membrane. 4. The change in membrane properties in the nociceptive pathways of nerve roots is one of the preconditions for perception of pain. As the authors' remark indicate, a better understanding of the pathophysiology of pain will lead to a more differentiated therapeutic approach.     

Ultrasound-guided pulsed radiofrequency of cervical nerve root for cervical radicular pain: a prospective randomized controlled trial

BACKGROUND CONTEXTPulsed radiofrequency (PRF) on cervical dorsal root ganglion (DRG) for pain management in cervical radicular pain is mainly performed via a transforaminal approach under fluoroscopic guidance. Ultrasound-guidance periradicular cervical nerve root intervention raises concern about the neuromodulatory effect. This study aims to evaluate the effectiveness and duration of pain relief between PRF treatment and steroid injection on the cervical nerve roots.PURPOSETo evaluate the efficacy of pulsed radiofrequency for cervical radicular pain.STUDY DESIGNA prospective, double-blinded, randomized controlled clinical trialPATIENT SAMPLEPatients who underwent ultrasound-guided periradicular cervical nerve root PRF or steroid injection from January 2020 to May 2021 at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand.OUTCOME MEASURESThe primary outcome was the pain score at 3 months postprocedure. The secondary outcomes were the duration of pain relief of at least 50%, pain scores at other time points after pain intervention, the amount of rescue pain medications, procedural time, and complications.METHODForty-two patients who presented with chronic cervical radicular pain were prospectively randomized into the PRF and steroid groups. Patients in the PRF group received PRF treatment at 42^°C for 4 minutes, followed by the injection of 2% lidocaine 1.5 mL and dexamethasone 10 mg to the targeted cervical nerve root. The steroid group received the same injectate. Patients and pain assessors were blinded. The numerical rating scale (NRS) and the Neck Disability Index (NDI) questionnaires were used for pain intensity and neck functional assessment before and after the procedure. Pain reduction was recorded up to a 9-month follow-up.RESULTSData analysis was obtained from 20 and 21 patients receiving PRF and steroid treatment, respectively. At 3-month postprocedure, there were 70% of patients in the PRF group reported 50% pain reduction compared with 23.8% of patients in the steroid group (p<.01). Moreover, patients in the PRF group had significantly less pain (NRS 2.8±2.7) compared with patients in the steroid group (NRS 5.5±2.6) (p=.01). The neck disability index demonstrated significant improvement at 3 and 6 months (p<.01) after PRF treatment compared with steroid injection alone. The duration, in which pain relief was at least 50%, was significantly longer in patients who received PRF treatment (6.0±4.1 months) compared with those in the steroid group (2.3±2.1 months) (p<.01).CONCLUSIONUltrasound-guided periradicular cervical nerve root PRF exhibited a neuromodulatory effect and was considered effective for patients with cervical radicular pain. It provided a longer duration of pain relief and improvement of neck function for up to 6 months.     

Does Norepinephrine Influence Pain Behavior Mediated by Dorsal Root Ganglia?: A Pilot Study

Background  

Postganglionic neurons in the sympathetic nervous system reportedly are involved in lumbar radicular pain and release norepinephrine (NE), a neurotransmitter. Increased numbers of sympathetic nerve fibers have been found in dorsal root ganglion (DRG) neurons in a root constriction model. Whether this is a reasonable model for pain, however, is unclear     

不同传入神经损伤对大鼠神经病理性痛形成的影响及其与脊髓和背根神经节BDNF的关系

目的 探讨不同传入神经损伤对大鼠神经病理性痛形成的影响及其与脊髓和背根神经节(DRG)脑源性神经营养因子(BDNF)的关系.方法 雄性SD大鼠24只,随机分为3组(n=8):假手术组(S组)、腓肠神经损伤组(SUR组)和腓肠肌-比目鱼肌(GS)神经损伤组(GS组).SUR组和GS组分别暴露腓肠神经和GS神经并剪断,S组仅暴露腓肠神经和GS神经而不剪断.于术前1 d和术后3、7 d时测定大鼠机械痛阈.于术后7 d痛阈测定结束后,取术侧L5的DRG和脊髓节段,测定脊髓背角的BDNF表达,计算BDNF阳性神经元和受损神经元(ATF-3阳性神经元)占总DRG神经元的百分比和ATF-3阳性神经元中BDNF阳性神经元的百分比.结果 与术前1 d时比较,GS组术后各时点机械痛阈降低(P＜0.01).与S组和SUR组比较,GS组机械痛阈降低,脊髓背角BDNF表达上调,BDNF阳性神经元占总DRG神经元的百分比升高(P＜0.01);S组和SUR组各指标比较差异无统计学意义(P＞0.05).与SUR组比较,GS组ATF-3阳性神经元占总DRG神经元的百分比差异无统计学意义(P＞0.05),而ATF-3阳性神经元中BDNF阳性神经元的百分比升高(P＜0.05).结论 切断来自大鼠骨骼肌的传入神经可形成神经病理性痛,其原因与上调DRG和脊髓背角中BDNF的表达有关;而切断来自皮肤的传入神经则不会形成神经病理性痛.