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Morphological Observation of Sympathetic Nerve Fibers in the Human Posterior Longitudinal Ligament

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

doi: 10.1097/BRS.0000000000000647
Anatomy
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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 (x2 = 0.969, P > 0.05).

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

Level of Evidence: 2

The objective was to investigate the fluorescent expression of sympathetic nerve fibers in the cervical posterior longitudinal ligament. Using glyoxylic acid-induced biological monoamine fluorescent technique and statistical analysis of the positive rate of fluorescence, our study found sympathetic nerve fibers were distributed in the human cervical posterior longitudinal ligament.

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

Address correspondence and reprint requests to Bohua Chen, MD, Department of Orthopedics, The Affiliated Hospital of Qingdao University (E District), 59 Haier Rd, Qingdao, Shandong, China, 266003; E-mail: bhchen@hotmail.com

Acknowledgment date: March 18, 2014. First revision date: April 26, 2014. Second revision date: July 9, 2014. Third revision date: August 9, 2014. Acceptance date: October 2, 2014.

The device(s)/drug(s) that is/are the subject of the manuscript is/are not intended for human use.

The National Scientific and Technological Major Special Project (H0609), the National Natural Science Foundation of China (81171758), research project from Qingdao University.

No relevant financial activities outside the submitted work.

© 2014 by Lippincott Williams & Wilkins