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Radicular pain - recent pathophysiologic concepts and therapeutic implications.
1Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden. kjell.olmarker@orthop.gu.se
Schmerz (Berlin, Germany)
|January 17, 2002
Summary
Sciatica may stem from biochemical changes in nerve roots caused by the intervertebral disk, not just mechanical pressure. Tumor necrosis factor (TNF) plays a key role, prompting trials for TNF-inhibiting sciatica treatments.
Area of Science:
- Neuroscience
- Biochemistry
- Orthopedics
Background:
- Sciatica pathogenesis is not fully understood.
- Mechanical compression is a known cause.
- A non-mechanical basis requires elucidation.
Purpose of the Study:
- To investigate the pathophysiologic mechanisms of sciatica.
- To explore the role of the intervertebral disk in nerve root changes.
- To identify biochemical mediators of sciatica.
Main Methods:
- Assessment of structural and functional changes in nerve roots.
- Local application of intervertebral disk material.
- Analysis of disk-related cytokines, including tumor necrosis factor (TNF).
Main Results:
- Intervertebral disk material can induce nerve root changes without mechanical compression.
- These disk-induced changes suggest a biologic/biochemical basis for sciatica.
- Tumor necrosis factor (TNF) is implicated as a mediator of these changes.
Conclusions:
- Sciatica may have a significant non-mechanical, biochemical component.
- Disk-derived TNF is a key factor in sciatica development.
- Targeting TNF presents a potential therapeutic strategy for sciatica.