Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Spine (Phila Pa 1976). 2012 Jul 15;37(16):1357-62. doi: 10.1097/BRS.0b013e31824ba710.
An immunohistological analysis of the cervical intervertebral disc (IVD).
To investigate sensory and autonomic innervation of the rat cervical IVD.
Many clinicians are challenged with treating wide-ranging chronic neck pain. Several authors have reported that sympathetic nerves participate in chronic pain, and various sympathectomy procedures can effectively treat chronic pain.
The neuro-tracer Fluoro-gold (FG) was applied to the anterior surfaces of C5-C6 IVDs from 10 Sprague-Dawley rats to label the neurons of the innervating dorsal root ganglion (DRG), stellate ganglion (SG; sympathetic ganglion), and nodose ganglion (NG; parasympathetic ganglion). Seven days postsurgery, DRGs from level C1-C8, SG, and NG neurons were harvested, sectioned, and immunostained for calcitonin gene-related peptide (CGRP; a marker for peptide-containing neurons) and isolectin B4 (IB4; a marker for nonpeptide-containing neurons). The proportion of FG-labeled DRG neurons that were CGRP-immunoreactive (CGRP-IR), IB4-binding, and non-CGRP-IR and IB4-binding, and the proportion of FG-labeled SG neurons and NG neurons were calculated.
FG-labeled neurons innervating the C5-C6 IVD were distributed throughout the C2-C8 DRGs. The proportions of FG-labeled DRG neurons that were CGRP-IR, IB4-binding, non-CGRP-IR and IB4-binding, as well as SG neurons, and NG neurons were 20.6%, 3.3%, 55.7%, 8.9%, and 11.5%, respectively. The proportion of CGRP-IR FG-labeled DRG neurons was significantly higher than the proportion of IB4-binding FG-labeled DRG neurons at each level (P < 0.05).
The C5-C6 IVD was innervated multisegmentally from neurons of the C2-C8 DRG, SG, and NG. Overall, 79.6% of the nerve fibers innervating the IVD were sensory nerves and 20.4% were autonomic nerves. Furthermore, 23.9% of the nerve fibers innervating the IVD were afferent sensory pain-related nerves, 8.9% were efferent sympathetic nerves, and 11.5% were efferent parasympathetic nerves. These findings may explain the wide-ranging and chronic discogenic pain that occurs via the somatosensory and autonomic nervous system.
颈椎间盘的免疫组织学分析。
研究大鼠颈椎间盘的感觉和自主神经支配。
许多临床医生在治疗广泛的慢性颈部疼痛方面面临挑战。一些作者已经报道，交感神经参与慢性疼痛，并且各种交感神经切除术可以有效地治疗慢性疼痛。
将神经示踪剂 Fluoro-gold（FG）应用于 10 只 Sprague-Dawley 大鼠的 C5-C6 椎间盘的前表面，以标记支配背根神经节（DRG）、星状神经节（SG；交感神经节）和结状神经节（NG；副交感神经节）的神经元。手术后 7 天，从 C1-C8 水平收获 DRG、SG 和 NG 神经元，切片并免疫染色降钙素基因相关肽（CGRP；含肽神经元的标志物）和异硫氰酸荧光素 B4（IB4；非肽含神经元的标志物）。计算 FG 标记的 DRG 神经元中 CGRP 免疫反应性（CGRP-IR）、IB4 结合、非 CGRP-IR 和 IB4 结合的比例，以及 FG 标记的 SG 神经元和 NG 神经元的比例。
支配 C5-C6 椎间盘的 FG 标记神经元分布于 C2-C8 DRG 中。CGRP-IR、IB4 结合、非 CGRP-IR 和 IB4 结合、SG 神经元和 NG 神经元的 FG 标记 DRG 神经元比例分别为 20.6%、3.3%、55.7%、8.9%和 11.5%。CGRP-IR FG 标记的 DRG 神经元的比例明显高于每个水平的 IB4 结合的 FG 标记的 DRG 神经元的比例（P <0.05）。
C5-C6 椎间盘从 C2-C8 DRG、SG 和 NG 的神经元多节段支配。总体而言，支配椎间盘的神经纤维中 79.6%为感觉神经，20.4%为自主神经。此外，支配椎间盘的神经纤维中有 23.9%为传入感觉相关疼痛神经，8.9%为传出交感神经，11.5%为传出副交感神经。这些发现可能解释了通过躯体感觉和自主神经系统发生的广泛和慢性椎间盘源性疼痛。
