Department of Spinal Surgery, The Third Medical Center of PLA General Hospital, Jinzhou Medical University Postgraduate Training Base，Beijing, P.R. China.
Pain Med. 2019 Jun 1;20(6):1072-1077. doi: 10.1093/pm/pnz013.
To investigate the distribution of nociceptive nerve fibers in the cervical intervertebral discs of patients with chronic neck pain and determine whether these nociceptive nerve fibers are related to discogenic neck pain.
We collected 43 samples of cervical intervertebral discs from 34 patients with severe chronic neck pain (visual analog scale [VAS] ≥ 70 mm), 42 samples from 36 patients who suffered cervical spondylotic radiculopathy or myelopathy without neck pain or with mild neck pain (VAS ≤ 30 mm) and 32 samples from eight donators to investigate their innervation immunohistochemically using an antibody against neuropeptide substance P.
The immunohistochemical investigation revealed that substance P-positive nerve fibers were obviously increased in number and deeply ingrown into the inner anulus fibrosus and even into the nucleus pulposus in the degenerative cervical discs of patients with severe neck pain in comparison with the discs of patients with cervical spondylotic radiculopathy or myelopathy and normal control discs (P<0.01).
The current study may indicate a key role of nociceptive nerve fibers in the pathogenesis of neck pain of cervical disc origin.
研究慢性颈痛患者颈椎间盘内伤害性神经纤维的分布情况，确定这些伤害性神经纤维与椎间盘源性颈痛的关系。
我们收集了 34 例严重慢性颈痛患者（视觉模拟评分[VAS]≥70mm）的 43 个颈椎间盘样本、36 例患有颈椎病神经根病或脊髓病但无颈痛或颈痛较轻（VAS≤30mm）的患者的 42 个样本以及 8 例捐赠者的 32 个样本，使用针对神经肽 P 物质的抗体进行神经支配免疫组织化学染色。
免疫组织化学研究显示，与颈椎病神经根病或脊髓病患者的椎间盘和正常对照椎间盘相比，严重颈痛患者退变颈椎间盘内 P 物质阳性神经纤维数量明显增多，且深入到内纤维环甚至髓核（P<0.01）。
本研究可能表明伤害性神经纤维在颈痛的发病机制中起关键作用。
