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Objective:To investigate the value of application of combined ultrasound and spinal CT/MRI-assisted lumbar puncture in spinal muscular atrophy (SMA) patients with spinal deformities.Methods:Twelve SMA patients with spinal deformities were evaluated for combined ultrasound and spinal CT/MRI imaging-assisted lumbar intrathecal administration of nusinersen between November 2021 and September 2022.The degree of difficulty of lumbar puncture in SMA patients was graded according to the spinal imaging, and then different puncture methods were designed according to different puncture difficulty grades.The success rate, preparation time, operation time, the number of attempts, and complications of lumbar puncture were counted.Results:In this study, 48 lumbar punctures were performed in 12 patients with SMA, with a success rate of 100%.The average preparation time for puncture was 13.60 min, the average puncture time was 4.96 min, and the average number of attempts was 1.33. No complications such as injury to the spinal cord, nerve and viscera were found in all patients.Conclusions:Combined ultrasound and spinal CT/MRI-assisted lumbar puncture has high value when applied for SMA patients with spinal deformities.
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Objective:To explore the effect of spinal interleutkin-33 (IL-33) on radicular pain in rats modeling non-compressive lumbar disc herniation.Methods:A total of 80 male Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a lentivirus negative control group, a low-dose IL-33 recombinant lentivirus group and a high-dose IL-33 group, each of 16. Non-compressive lumbar disc herniation was successfully induced in all except the rats in the sham operation group. Two days later, the model group was injected intrathecally with 10μl of enhanced infection solution. The lentivirus control group received 10μl of negative lentivirus, the low-dose IL-33 recombinant lentivirus group received 5μl of IL-33 recombinant lentivirus and the high-dose IL-33 recombinant lentivirus group received 10μl of IL-33 recombinant lentivirus. The 50% paw withdrawal threshold (50% PWT) was measured one day before the modeling and on the 1 st, 3 rd, 5 th, 7 th, 9 th, 11 th, 13 th, 15 th, 17 th, 19 th, and 21 st day afterward. On the 12 th day the expressions of IL-33 protein and mRNA were evaluated. Results:The average expression of IL-33 protein and mRNA in the model and the lentivirus negative control group increased significantly after the modelling compared with the sham group, while expression in the low- and high-dose IL-33 recombinant lentivirus groups was significantly lower than in the lentivirus negative control group. Compared with one day before the modelling, average 50% PWTs on the affected side decreased significantly in all of the modelling groups. From the 9 th to the 21 st day significantly increased 50% PWTs were observed on the affected side in the low-dose and high-dose IL-33 recombinant lentivirus groups compared with the other two modelling groups. Immunostaining showed significant increase in the expression of IL-33 in the dorsal horn of the spinal cord in the model group, compared with the sham operation group. Significant decrease in the average expression of IL-33 in the spinal dorsal horns was observed in the low-dose and high-dose IL-33 recombinant lentivirus groups. Conclusions:Intervertebral disk herniation may increase the expression of IL-33 in the spinal cord, and may cause radicular pain.
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Interleukin-33 (IL-33),a novel member of IL-1 family,is a multifunctional cytokine.IL-33 can act as a transcriptional repressor.It can also bind to growth stimulation expressed gene 2 protein (ST2) to induce the activation of some inflammatory cells.IL-33 is extensively expressed in nervous system.Some studies showed that the levels of IL-33 and ST2 were significantly changed in pain.Some reports demonstrated that the IL-33/ST2 signaling pathway played critical roles in them.This present article will review the biological characteristics of IL-33/ST2 and their expressions in nervous system and significance of interventional pain related diseases.
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Objective To investigate the effect of lipoxin A4 LXA4) on radicular pain caused by intervertebral disc herniation.Methods Non-compressive intervertebral disc herniation was induced into forty-eight adult male Sprague-Dawley rats,and they were divided into a sham group (sham operation + 10 μl normal saline),a control group (modeled + 10 μl normal saline),an LXA4 10 ng group (modeled + 10 ng LXA4) and an LXA4 100 ng group (modeled + 100 ng LXA4),with 12 rats in each group.The normal saline (10 μl) or LXA4 (10 μl) was administered intrathecally right after the operation and on each of the three succeeding days.General behavior was observed and the 50％ paw withdrawal threshold (50％ PWT) was measured.On postoperative day 7 all the rats were killed and the ipsilateral lumbar (L4~) segments of their spinal dorsal horns were removed for determination of the expression of p-JNK,t-JNK,p-ERK and t-ERK proteins using western blotting.TNF-α,IL-1β and TGF-β1 expression were determined using ELISA.Results There was no significant difference in the 50％PWT of the sham group before and after surgery,but the 50％ PWTs of the control group and the LXA4 10 ng group were significantly decreased after the operation compared with their values beforehand and significantly lower than the value of the sham group at all time points.Moreover,the 50％ PWT of the LXA4 10 ng group on postoperative days 3 and 5 was significantly higher than the control group;as was the value of the LXA4 100 ng group on postoperative days 2,3,4,5,6 and 7.The p-JNK and p-ERK expression in the control group,the LXA4 10 ng group and the LXA4 100 ng group were all increased significantly more than in the sham group,but their expression in the LXA4 10 ng group and LXA4 100 ng group were decreased significantly more in a dose-dependent manner compared with the control group,with the LXA4 100 ng group showing the greatest decrease.There were no significant differences in t-JNK or t-ERK expression within each group.Conclusion LXA4 can alleviate radicular pain caused by non-compressive lumbar intervertebral disc herniation.The underlying mechanism involves inhibiting the activation of the ERK and JNK pathways,reducing the expression of pro-inflammatory cytokines and increasing the expression of anti-inflammatory cytokines.
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Retrospective analysis was performed for 68 sacroiliac joint pain patients treated at our hospital from June 2007 to March 2012.And 27 patients received sacroiliac joint ozone injection,and others anti-inflammatory and analgesic solution.Both methods can significantly relieve sacroiliac joint pain (P ＜ 0.05).However there was no inter-group difference (P ＞ 0.05).No difference existed in efficacy [(0.51 ±0.03) vs.(0.34 ±0.06) cm],treatment frequency (1.98 ±0.94) vs.(1.82 ±0.88) or hospitalization duration [(14.6 ± 7.0) vs.(14.9 ± 6.4) days] between two groups (P ＞ 0.05).Thus sacroiliac joint ozone injection can significantly relieve sacroiliac joint pain and its effect is similar to anti-inflammatory analgesic injection.
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Objective To investigate the expression of nuclear factor kappa B(NF-Κb)in the lumbar spinal cord in chronic constrictive injury(CCI)of the sciatic nerve.Methods Foay-eight male Sprague-Dawley rats were divided into 2 groups(n=24 in each).The operation group received CCI of the sciatic nerve and the sham-operation group received a sham operation as a control.Their mechanical and thermal nociceptive thresholds were assessed with paw withdrawal latency (PWL) using von Frey filaments and radiant heating.Four rats were sacrificed at each time point and segments of their lumbar spinal cords were examined using Western blotting.Results Mechanical and thermal stimulation thresholds were reduced significantly after the operation.Expression of NF-Κb protein increased significantly in the ipsilateral dorsal horn of the spine compared with the contralateral side and compared with the sham-operation group.NF-Κb protein expression began to increase on the 1 st day after the operation,reached a peak at the 7th day,and stayed high throughout the experiment.Conclusion NF-Κb in the dorsal horn of the spine may be involved in neuropathie pain after CCI.