臨床整形外科50巻9号

2015年09月発行

Lecture

椎間板ヘルニアの発痛機序—その基礎研究の現状と課題

著者： 川上守¹

所属機関： ¹公立大学法人和歌山県立医科大学附属病院紀北分院脊椎ケアセンター

ページ範囲：P.883 - P.888

はじめに

　腰椎椎間板ヘルニアは腰下肢痛を惹起する疾患の1つであり，その発痛機序に関する多くの報告がなされているが，いまだ十分解明されているとは言いにくい．椎間板ヘルニア手術で採取した組織を用いた場合には，椎間板ヘルニアそのものか，それに伴う反応性組織なのか検討が必要となる．椎間板ヘルニアの動物モデルを用いれば，椎間板組織のみならず神経根，後根神経節ならびに中枢神経系の変化を詳細に検証することが可能である．また，動物の行動や圧や熱刺激に対する反応を観察することで疼痛を評価することが可能である．われわれは椎間板組織の神経根上への留置や神経根結紮のラットモデルを用いて，椎間板組織による疼痛発現機序の解明を試みてきた¹⁷⁾．本稿では，椎間板ヘルニアモデルを用いた基礎研究の現状と問題を検証し，今後の課題について述べる．

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