Pathophysiology of Compressive Radiculopathy

Česká verzia

Authors: R. Jančálek ^1,2; P. Dubový ²; Z. Novák ¹
Authors place of work: Ne urochirurgická klinika LF MU a FN u sv. Anny v Brně ¹; Oddělení ne uro anatomi e Anatomického ústavu LF MU, Brno ²
Published in the journal: Cesk Slov Neurol N 2008; 71/104(4): 405-413
Category: Review Article

Podporováno granty GAČR 309/ 07/ 0121 a MSM0021622404.

Summary

A relati onship between compressi on of the spinal ro ots and radiculopathy was described by Mixter and Barr in 1934. However, the compressi on of an intact spinal ro ot le ads only to paraesthesi a and does not explain the inducti on of radicular ne uropathic pain. Recent experimental and clinical studi es de aling with the discogenic eti ology of radiculopathy have documented the essenti al role of an inflammatory re acti on for the inducti on of clinical symptomatology. Therefore, the pathophysi ology of compressi on radiculopathy may be considered multifactori al. A mechanical effect during compressi on of the spinal ro ots le ads to changes of blo od supply and direct injury to nervo us tissue. Changes of connective tissue with endone uri al fibrosis prevail during chronic compressi on. An injury to the spinal ro ots also le ads to rele ase of pro inflammatory cytokines and the invasi on of macrophages. The prolapsed tissue of the intervertebral disc can also play an active role in the formati on of a pro- inflammatory environment. The inflammatory re acti on cre ates the conditi ons that ca use irritati on of the spinal ro ots and inducti on of the radicular ne uropathic pain. An accurate understanding of both the mechanical and the inflammatory roles in compressi on radiculopathy allows selecti on of an optimal tre atment strategy.

Key words:
spinal ro ot – compressi on – vascular supply – inflammati on – macrophage – cytokine

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