RESUMEN
The facet joint is a common source of neck pain, particularly after excessive stretch of its capsular ligament. Peptidergic afferents have been shown to have an important role in the development and maintenance of mechanical hyperalgesia, dysregulated nociceptive signaling, and spinal hyperexcitability that develop after mechanical injury to the facet joint. However, the role of non-peptidergic isolectin-B4 (IB4) cells in mediating joint pain is unknown. Isolectin-B4 saporin (IB4-SAP) was injected into the facet joint to ablate non-peptidergic cells, and the facet joint later underwent a ligament stretch known to induce pain. Behavioral sensitivity, thalamic glutamate transporter expression, and thalamic hyperexcitability were evaluated up to and at day 7. Administering IB4-SAP prior to a painful injury prevented the development of mechanical hyperalgesia that is typically present. Intra-articular IB4-SAP also prevented the upregulation of the glutamate transporters GLT-1 and EAAC1 in the ventral posterolateral nucleus of the thalamus and reduced thalamic neuronal hyperexcitability at day 7. These findings suggest that a painful facet injury induces changes extending to supraspinal structures and that IB4-positive afferents in the facet joint may be critical for the development and maintenance of sensitization in the thalamus after a painful facet joint injury.
Asunto(s)
Transportador 2 de Aminoácidos Excitadores/metabolismo , Lectinas/metabolismo , Neuronas Aferentes/fisiología , Dolor/fisiopatología , Proteínas Inactivadoras de Ribosomas Tipo 1/metabolismo , Tálamo/fisiopatología , Articulación Cigapofisaria/lesiones , Animales , Transportador 3 de Aminoácidos Excitadores/metabolismo , Hiperalgesia/fisiopatología , Lectinas/farmacología , Masculino , Estimulación Física , Ratas , Proteínas Inactivadoras de Ribosomas Tipo 1/farmacología , Saporinas , Tálamo/metabolismo , Núcleos Talámicos Ventrales/metabolismo , Articulación Cigapofisaria/inervaciónAsunto(s)
Terapias Complementarias/psicología , Terapias Complementarias/estadística & datos numéricos , Fibromialgia/terapia , Dolor de la Región Lumbar/terapia , Traumatismos Vertebrales/cirugía , Vértebras Cervicales/patología , Vértebras Cervicales/cirugía , Quiropráctica/estadística & datos numéricos , Terapias Complementarias/economía , Fibromialgia/psicología , Humanos , Luxaciones Articulares/patología , Luxaciones Articulares/cirugía , Dolor de la Región Lumbar/economía , Satisfacción del Paciente/estadística & datos numéricos , Efecto Placebo , Traumatismos Vertebrales/patología , Articulación Cigapofisaria/lesiones , Articulación Cigapofisaria/cirugíaRESUMEN
We present a case of septic arthritis of a lumbar facet joint with an associated epidural abscess. A 13-year-old boy was hospitalized with acute severe back pain and fever after pyonex was done. The infection was precisely localized with magnetic resonance imaging, bone and gallium scintigraphy. He responded to antibiotic therapy. We suppose that the infection was caused by pyonex because the blood cultures were negative, and the patient had an abrupt onset of severe pain and fever 24 h after the acupuncture.