Farrell Scott F, Osmotherly Peter G, Cornwall Jon, Rivett Darren A
Faculty of Health and Medicine, The University of Newcastle, University Drive, Callghan 2308, NSW, Australia.
Faculty of Health and Medicine, The University of Newcastle, University Drive, Callghan 2308, NSW, Australia.
Spine J. 2016 Oct;16(10):1244-1252. doi: 10.1016/j.spinee.2016.06.004. Epub 2016 Jun 11.
Innervation of anatomical structures is fundamental to their capacity to generate nociceptive impulses. Cervical spine meniscoids are hypothesized to be contributors to neck pain; however, their innervation is not comprehensively understood.
This study aimed to examine the presence and morphology of nerve fibers within cervical spine meniscoids and adjacent joint capsules.
This is a cross-sectional study.
The sample consists of cervical hemispines of 12 embalmed cadavers (mean [standard deviation] age 82.9 [6.5] years, six female, six left). Either the right or the left half of the cervical spine (hemispine) of each cadaver was included in the sample. So six left sides and six right sides of the cadaver cervical spines made up the 12 hemispines that formed the sample.
Cervical spine meniscoids and adjacent joint capsules were excised from lateral atlantoaxial and cervical zygapophyseal (C2-C3 to C6-C7) joints (n=67), then paraffin embedded. Meniscoids were sectioned sagittally (5 µm), slide mounted, and immunohistochemistry was performed using primary antibodies to neurofilament heavy (NF-H) and pan-neurofilament (Pan-NF) to identify nerve tissue. The study was supported by institutional graduate student funding. The authors have no conflicts of interest to declare.
Seventy-seven meniscoids (23 lateral atlantoaxial, 54 cervical zygapophyseal) were extracted and processed (154 sections in total). Sixty-four individual nerve fiber bundles were identified (26 NF-H positive, 38 Pan-NF positive) from 14 meniscoids. Nerves immunoreactive to both NF-H and Pan-NF were identified in 13 of 77 meniscoids (10 of 14 lateral atlantoaxial joint) from 11 joints (eight cadavers). Nerves were always located in joint capsules except three exclusively Pan-NF immunoreactive nerve fiber bundles from two adipose meniscoids.
The low nerve prevalence in elderly cervical spine meniscoids, with nerves only found in two adipose type meniscoids, suggests these structures may play a minimal role in cervical nociception generation in this demographic. The joint capsules, which were more frequently innervated, appear to be more likely generators of nociception in the elderly. Joint capsule nerves were mostly NF-H positive, indicating potential Aδ-fiber presence.
解剖结构的神经支配对于其产生伤害性冲动的能力至关重要。颈椎半月板被认为是颈部疼痛的原因之一；然而，其神经支配情况尚未得到全面了解。
本研究旨在检查颈椎半月板及相邻关节囊内神经纤维的存在情况和形态。
这是一项横断面研究。
样本包括12具防腐尸体的颈椎半侧（平均[标准差]年龄82.9[6.5]岁，6名女性，6名左侧）。每具尸体的颈椎右半侧或左半侧（半侧颈椎）被纳入样本。因此，尸体颈椎的6个左侧和6个右侧组成了构成样本的12个半侧颈椎。
从寰枢外侧关节和颈椎关节突关节（C2-C3至C6-C7）切除颈椎半月板及相邻关节囊（n=67），然后进行石蜡包埋。半月板矢状切片（5μm），载玻片固定，使用抗神经丝重链（NF-H）和泛神经丝（Pan-NF）一抗进行免疫组织化学以识别神经组织。该研究得到机构研究生基金的支持。作者声明无利益冲突。
共提取并处理了77个半月板（23个寰枢外侧关节半月板，54个颈椎关节突关节半月板）（共154个切片）。从14个半月板中识别出64个单独的神经纤维束（26个NF-H阳性，38个Pan-NF阳性）。在来自11个关节（8具尸体）的77个半月板中的13个（14个寰枢外侧关节半月板中的10个）中识别出对NF-H和Pan-NF均有免疫反应的神经。神经总是位于关节囊内，除了来自两个脂肪性半月板的三个仅对Pan-NF有免疫反应的神经纤维束。
老年颈椎半月板中神经分布率较低，仅在两个脂肪型半月板中发现神经，这表明这些结构在该人群的颈椎伤害感受产生中可能起最小作用。神经支配更频繁的关节囊似乎更有可能是老年人伤害感受的产生部位。关节囊神经大多为NF-H阳性，表明可能存在Aδ纤维。
