What are the causative mechanisms for symptomatic radiculopathy in low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

Research has revealed other possible causative mechanisms for symptomatic radiculopathy. A 1987 animal study showed that autologous nucleus pulposus placed in the epidural space of dogs produced a marked epidural inflammatory reaction that did not occur in the comparison group, which received saline injections. [31] Similar studies have shown that myelin-related and axonal injury to nerve roots exposed to autologous nucleus pulposus demonstrate reduced nerve conduction velocities. [32]

However, recent studies have demonstrated that experimental exposure of nerve roots to degenerative nucleus pulposus and annulus fibrosis does not produce the same dysfunctional neural changes; therefore, viable cells of the nucleus pulposus are necessary to induce localized neural dysfunction and generate algogenic agents, such as metalloprotease (eg, collagenase, gelatinase), IL-6, and prostaglandin-E2.


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