Publication details

Patofyziologie kompresivní radikulopatie

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Title in English Pathophysiology of Compressive Radiculopathy
Authors

JANČÁLEK Radim DUBOVÝ Petr NOVÁK Zdeněk

Year of publication 2008
Type Article in Periodical
Magazine / Source Česká a slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Field Neurology, neurosurgery, neurosciences
Keywords spinal root; compression; vascular supply; inflammation; macrophage; cytokine
Description A relationship between compression of the spinal roots and radiculopathy has been described by Mixter and Barr in 1934. Nevertheless, the compression of intact spinal root leads only to paraesthaesia and does not explain induction of the radicular neuropathic pain. Recent experimental and clinical studies dealing with discogenetic etiology of the radiculopathy has documented essential role of the inflammatory reaction for induction of a clinical symptomatology. Therefore, the pathophysiology of compression radiculopathy is mutlifactorial. A mechanical effect during compression of the spinal roots leads to changes of blood supply and direct injury of a nervous tissue. Changes of connective tissue with endoneurial fibrosis prevail during a chronic compression. An injury to the spinal roots leads also to release of proinflammatory cytokines and invasion of macrophages. A prolapsed tissue of intervertebral disc can also play an active role in formation of the proinflammatory environment. The inflammatory reaction creates conditions for irritability of the spinal roots and induction of the radicular neuropathic pain. A correct understanding of the mechanical and inflammatory concept of the compression radiculopathy allows selection of optimal treatment strategy.
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