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Kentaro Okada,Seiji Ohtori,Gen Inoue,Sumihisa Orita,Yawara Eguchi,Junichi Nakamura,Yasuchika Aoki,Tetsuhiro Ishikawa,Masayuki Miyagi,Hiroto Kamoda,Miyako Suzuki,Gou Kubota,Yoshihiro Sakuma,Yasuhiro Oi 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.3
Study Design: Prospective study. Purpose: To examine the long-term effects of interspinous ligament injections of local anesthetics and steroids for the treatment of Baastrup’s diseases. Overview of Literature: Baastrup’s disease is associated with axial low back pains. Baastrup’s disease has been more recently described as the “kissing spinous processes” disease. Several authors have reported methods for the diagnosis and treatment of the disease. However, there has been only one report of patients receiving interspinous ligament injections of agents for the treatment of Baastrup’s disease. Methods: Seventeen patients showed severe low back pains between spinous processes at L3–L4 or L4–L5. X-ray imaging, computed tomography, and magnetic resonance imaging revealed kissing spinous processes, consolidation of spinous process, or inflammation of an interspinous ligament. Pain reliefs after lidocaine and dexamethasone administration into interspinous ligament as therapy for low back pains were being examined and followed up. Results: Low back pain scores significantly improved immediately after injection of the agents into interspinous ligaments. At final follow-up (1.4 year), low back pain scores significantly improved as compared with before the treatment. Conclusions: Findings from the current study indicate that lidocaine and dexamethasone administration into interspinous ligament in patients diagnosed with Baastrup’s disease is effective for managing the pain associated with this disease.
Kensuke Yoshino,Seiji Ohtori,Miyako Suzuki,Yuya Kawarai,Yoshihiro Sakuma,Gen Inoue,Sumihisa Orita,Kazuyo Yamauchi,Yasuchika Aoki,Tetsuhiro Ishikawa,Masayuki Miyagi,Hiroto Kamoda,Gou Kubota,Yasuhiro Oi 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.6
Purpose: Transient receptor potential vanilloid 1 (TRPV1) is a ligand-gated nonselectivecation channel, which can be activated by capsaicin and other noxious stimuli. Recently, an association between bone pain and TRPV1 has been reported. However, the influence of osteoporosis on TRPV1 in the sensory system innervatingthe femur has not been reported. Materials and Methods: TRPV1-immunoreactive(ir) in dorsal root ganglia (DRG) neurons labeled with neurotracer [Fluoro-Gold (FG)] innervating the femurs of Sprague Dawley rats were examined in control, sham, and ovariectomized (OVX) rats. We evaluated osteoporosis in the femursand compared the proportion of TRPV1-ir DRG neurons innervating femur between the 3 groups of rats. Results: OVX rats showed osteoporotic cancellous bone in the femur. FG labeled neurons were distributed from L1 to L6 DRG, but there was no significant difference in the proportion of labeled neurons between the 3 groups (p>0.05). The proportions of FG labeled TRPV1-ir DRG neurons were 1.7%, 1.7%, and 2.8% of DRG neurons innervating the femur, in control, sham-operated,and OVX rats, respectively. The proportion of TRPV1-ir neurons in DRG innervating the femur in OVX rats was significantly higher than that in control and sham-operated rats (p<0.05). Conclusion: Under physiological conditions, DRG neurons innervating femurs in rats contain TRPV1. Osteoporosis increases the numbers of TRPV1-ir neurons in DRG innervating osteoporotic femurs in rats. These findings suggest that TRPV1 may have a role in sensory perception of osteoporoticfemurs.