Immunohistochemical demonstration of nerve fibers in the synovial fold of the human cervical facel joint

The role of the intra-articular synovial fold as a source of facet joint pain is unclear, because the nature of nociceptive innervation in lumbar synovial folds is controversial, and there have been no such studies in cervical synovial folds. The present study aimed to demonstrate the presence of nerve fibers including nociceptive fibers in synovial folds of human cervical facet joints using immunohistochemistry. Synovial folds of cervical facet joints removed from patients undergoing cervical spine laminoplasty were analyzed immunohistochernically using antibodies to protein gene product 9.5, p 111-tubulin, substance P and calcitonin gene-related peptide. Many nerve fibers immunoreactive for protein gene product 9.5 and 111-tubulin were demonstrated both around blood vessels and as free fibers in the stroma of the synovial fold. Also, immunostaining showed the presence of free nerve fibers immunoreactive for substance P and calcitonin gene-related peptide in the stroma. The presence of putative nociceptive fibers in cervical synovial folds supports a possible role for these structures as a source of cervical facet joint pain. 0 3001 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

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