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人后纵韧带中交感神经纤维的形态学观察

Morphological observation of sympathetic nerve fibers in the human posterior longitudinal ligament.

作者信息

Li Haiyan, Ma Xuexiao, Wu Xiaolin, Liu Fengxia, Yu Tengbo, Yue Bin, Xiang Hongfei, Chen Bohua

机构信息

From the Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Spine (Phila Pa 1976). 2014 Dec 15;39(26):2119-26. doi: 10.1097/BRS.0000000000000647.

Abstract

STUDY DESIGN

Histological study of human living tissue.

OBJECTIVE

To determine sympathetic fiber in the cervical posterior longitudinal ligaments (PLL) obtained from the patients undergoing anterior cervical decompression surgery, and speculate the implication of their presence and distribution.

SUMMARY OF BACKGROUND DATA

The pathogenic mechanism responsible for cervical spondylosis remains unclear. Cervical vertigo is often confused with aural vertigo, and central vertigo, and et al. It has been gradually realized that mechanical interference to the vertebral artery is not the only way to explain the pathogenic mechanism of cervical vertigo. It should be noted that the sympathetic factor may also involve it because some sympathetic nerves were found in the PLL in an animal study of intervertebral discs. Although it is unclear whether there is a similar phenomenon in adult human PLL.

METHODS

Forty-six patients who received anterior cervical decompression surgery in The Affiliated Hospital of Qingdao University from January 2013 to December 2013 were classified into 2 groups: with cervical spondylosis and with cervical trauma. Cervical PLL tissues of all the participants were obtained during operation. The paraffin slices of the ligament were stained according to glyoxylic acid-induced fluorescent method. The morphology and distribution of sympathetic nerve fibers were observed by measuring and analyzing fluorescent units expressed on different sections. The positive rates expressed by fluorescent staining were statistically analyzed.

RESULTS

Different forms of sympathetic nerve fibers distribution were observed in the 3-dimensional slices in each group selected from 46 cases of specimens. The positive rate of fluorescent units detected from the cervical PLL in patients experiencing cervical spondylosis was not significantly different from that in cervical trauma group (x = 0.969, P > 0.05).

CONCLUSION

Sympathetic nerve fibers were confirmed to distribute in the human cervical posterior longitudinal ligament.

LEVEL OF EVIDENCE

摘要

研究设计

人体活组织的组织学研究。

目的

确定从接受颈椎前路减压手术患者获取的颈后纵韧带(PLL)中的交感神经纤维,并推测其存在及分布的意义。

背景资料总结

颈椎病的致病机制仍不清楚。颈性眩晕常与耳性眩晕、中枢性眩晕等相混淆。人们逐渐认识到,对椎动脉的机械性干扰并非解释颈性眩晕致病机制的唯一途径。应当注意的是,交感神经因素可能也与之有关,因为在椎间盘的动物研究中发现PLL中有一些交感神经。尽管尚不清楚在成年人体PLL中是否存在类似现象。

方法

将2013年1月至2013年12月在青岛大学附属医院接受颈椎前路减压手术的46例患者分为两组:颈椎病组和颈椎创伤组。所有参与者的颈PLL组织均在手术中获取。韧带的石蜡切片按照乙醛酸诱导荧光法进行染色。通过测量和分析不同切片上表达的荧光单位观察交感神经纤维的形态及分布。对荧光染色所表达的阳性率进行统计学分析。

结果

从46例标本中每组选取的三维切片中观察到不同形式的交感神经纤维分布。颈椎病患者颈PLL检测到的荧光单位阳性率与颈椎创伤组相比无显著差异(x = 0.969,P > 0.05)。

结论

证实交感神经纤维分布于人类颈后纵韧带。

证据级别

2级。

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