Abstract
OBJECTIVE: To learn how lesions with differing capacity for nerve regeneration affect the severity and duration of hyperalgesia in an animal model of neuropathic pain. METHODS: Three groups of rats were studied: 1) L5 nerve root crush (favorable for regeneration); 2) L5 root ligation and section; and 3) sham-operated group. An experimenter who did not know the rats' groups tested the animals for hyperalgesia to mechanical and cold stimuli. RESULTS: Measures of adverseness of mechanical and cooling stimuli for the crush group and ligation/cut groups were significantly higher than for the sham-operated group (P < 0.001 for both) for the first 30 days after lesioning. By 40 days, the crush group recovered from mechanical hyperalgesia, whereas the ligation/cut group continued to have significant hyperalgesia. At this time, both lesion groups displayed hyperalgesia to the cooling stimulus (P < 0.001), but the hyperalgesia in the ligation/cut group was significantly greater (P < 0.01). No recovery from cooling hyperalgesia was evident during the 54-day period of observation. Histological studies of the sciatic nerve indicated higher numbers of regenerating fibers in the crush group compared with the ligation/cut group. CONCLUSION: This study demonstrates that axotomy, regardless of how it is induced, produces hyperalgesia to both mechanical and cold stimuli. However, the lesion that favors regeneration is associated with earlier signs of recovery from mechanical hyperalgesia and less severe signs of cooling hyperalgesia. The data support the hypothesis that inputs from the injured afferents play an ongoing role in neuropathic pain from nerve injury. Nerve ligation induces more severe and more sustained behavioral signs of pain than nerve crush.
Original language | English (US) |
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Pages (from-to) | 1200-1209 |
Number of pages | 10 |
Journal | Neurosurgery |
Volume | 53 |
Issue number | 5 |
DOIs | |
State | Published - Nov 2003 |
Keywords
- Axotomy
- Causalgia
- Complex regional pain syndrome
- Nerve injury
- Neuroma
- Neuropathic pain
- Neuropathy
ASJC Scopus subject areas
- Surgery
- Clinical Neurology