Shang Qiliang, Wang Dong, Wang Di, Peng Pandi, Wang Han, Jia Haoruo, Mao Jianxin, Gao Chu, Du Mu, He Xin, Ma Yachao, Zheng Chao, Yang Liu, Luo Zhuojing, Hu Xueyu
Institute of Orthopedic Surgery, Xijing Hospital Fourth Military Medical University Xi'an People's Republic of China.
Medical Research Institute Northwestern Polytechnical University Xi'an People's Republic of China.
JOR Spine. 2023 Jan 2;6(1):e1241. doi: 10.1002/jsp2.1241. eCollection 2023 Mar.
This study aims to emphasize the initiating role of facet joint (FJ) degeneration in the process of cervical spine degeneration induced by tangential load, and we further validate it in a novel cervical spine degeneration animal model.
The characteristics of cervical degeneration in patients of different ages were summarized through case collection. In the rat models, Hematoxylin-Eosin, Safranin O staining, and micro-computed tomography were used to show the histopathological changes and bone fiber structure of FJ and the height of intervertebral disc (IVD) space. The ingrowth of nociceptive sensory nerve fibers was observed by immunofluorescence staining.
FJ degeneration without IVDs degeneration was more common in people with cervical spondylosis in young patients. The obvious degeneration phenotypes of the FJs preceded the IVDs at the same cervical segment in our animal model. The SP and CGRP sensory nerve fibers were observed in the articular subchondral bone of degenerated FJs and porous endplates of degenerated IVDs.
The FJ degeneration may act as the major contributor to cervical spine degeneration in young people. The dysfunction of functional unit of spine, not a certain part of IVD tissue, results in the occurrence of cervical degeneration and neck pain.
本研究旨在强调小关节（FJ）退变在切线负荷诱导的颈椎退变过程中的起始作用，并在一种新型颈椎退变动物模型中进一步验证。
通过病例收集总结不同年龄患者颈椎退变的特征。在大鼠模型中，采用苏木精-伊红染色、番红O染色和微型计算机断层扫描来显示FJ的组织病理学变化、骨纤维结构以及椎间盘（IVD）间隙高度。通过免疫荧光染色观察伤害性感觉神经纤维的长入。
在年轻颈椎病患者中，无IVD退变的FJ退变更为常见。在我们的动物模型中，同一颈椎节段的FJ明显退变表型先于IVD出现。在退变FJ的关节软骨下骨和退变IVD的多孔终板中观察到P物质（SP）和降钙素基因相关肽（CGRP）感觉神经纤维。
FJ退变可能是年轻人颈椎退变的主要原因。脊柱功能单元功能障碍，而非IVD组织的某一特定部分，导致颈椎退变和颈部疼痛的发生。
