颈椎间盘与后纵韧带上交感神经的解剖学观察及在颈椎间盘源性疼痛中作用的探讨

Sympathetic nerve fibers of the cervical intervertebral disc and posterior longitudinal ligament:anatomical research and the role in cervical discogenic pain

目的观察颈椎间盘及后纵韧带上交感神经的分布特点并探讨其在颈椎间盘源性疼痛中的作用。方法分别切取8只兔子颈椎间盘及颈椎后纵韧带,用冰冻切片-乙醛酸(SPG)法对其交感神经纤维进行特异性染色,荧光显微镜观察并辅以图像分析软件(Image-proplus5.0)观察其分布特点。结果颈椎间盘外环有少量交感神经节后纤维,颈椎后纵韧带椎间盘区有大量密集的交感神经节后纤维,它们互相交叉成网状或排列成丛状,且有着复杂的三维空间联系。分布于后纵韧带浅层的交感神经较深层密集(P<0.05)。结论分布于颈椎间盘外环及后纵韧带上的交感神经纤维是感受颈椎间盘紊乱、病变刺激的生理基础,可能在颈椎间盘源性疼痛发病中起着重要作用。

Objective To study the distribution of the sympathetic nerve fibers in the rabbit cervical intervertebral disc and posterior longitudinal ligament,and approach the role in cervical discogenic pain. Methods The cervical posterior longi-tudinal ligament and intervertebral discs of 8 rabbits were cut and stained by Sucrose-Phosphate-glyoxylic acid （SPG） method to display the sympathetic nerve fibers. The sympathetic nerve fibers distributed in the posterior longitudinal ligament and intervertebral disc was observed and analyzed by fluorescent-microscope and Image-pro plus 5.0. Results Only a few sympathetic postganglionic fibers were found in outer layer of annulus fibrosus of intervertebral disc, and a large number of sympathetic postganglionic fibers were found in the cervical posterior longitudinal ligament. They were crossed each other and form a web and plexus, at the same time, they had a complex three-dimension relationship. The density of sympathetic fibers in the superficial layer was higher than those in deep layer （P 〈0.05）. Conclusion The distribution of the sympathetic nerve fibers in the cervical intervertebral disc and posterior longitudinal ligament may be the physiological fundament which received the stimulus came from intervertebral disc disorder, and they maybe had played an important role in cervical discogenic pain.