Objective: To explore the patterns of innervation of cervical facet joints and determine the pathways from facet joints to dorsal root ganglions (DRGs) in order to clarify the causes of diffuse neck pain, headache, and shoulder pain.
Methods: Forty-two male-Sprague-Dawley rats, weighing 250-300 g, were randomly divided into three groups: Group A (n=18), Group B (n=18), and Group C (n=6). Under anesthesia with intraperitoneal pentobarbital sodium (45 mg/kg body weight), a midline dorsal longitudinal incision was made over the cervical spine to expose the left cervical facet joint capsule of all the rats under a microscope. The rats in Group A underwent sympathectomy, but the rats in Group B and Group C did not undergo sympathectomy. Then 0.6 microlitre 5% bisbenzimide (Bb) were injected into the C1-2, C3-4 and C5-6 facet joints of 6 rats respectively in Group A and Group B. The holes were immediately sealed with mineral wax to prevent leakage of Bb and the fascia and skin were closed. But in Group C, 0.9% normal saline was injected into the corresponding joint capsules. Then under deep re-anesthesia with intraperitoneal pentobarbital sodium (45 mg/kg body weight), C1-C8 left DRGs in all rats and the sympathetic ganglions in Group B were obtained and the number of the labeled neurons was determined.
Results: Neurons labeled with Bb were present in C1-C8 DRGs in both Group A and Group B, and sympathetic ganglions in Group B. In the C1-2 and C3-4 subgroups, labeled neurons were present from C1 to C8 DRGs, while in C5-6 subgroups they were from C3 to C8. The number of Bb(+) neurons after sympathectomy was not significantly different in the injected level from that without sympathectomy. But in the other levels, the number of Bb(+) neurons after sympathectomy was significantly less than that without sympathectomy.
Conclusions: The innervation of the cervical facet joints is derived from both sensory and sympathetic nervous system, and DRGs are associated with sympathetic ganglions through nerve fibers outside the central nerve system.
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BMJ Case Rep
January 2025
Neurosurgery, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
Cervical fracture dislocation often leads to neurological deficits, manifesting with sensory and motor symptoms, which may persist even after surgical intervention. We presented two cases with mild neurological deficits following such injuries. In Case 1, the patient presented with left-hand numbness 1 month after a car accident.
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February 2025
Department of Anesthesiology and Pain Management, Leiden University Medical Center, Leiden, The Netherlands.
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Eur Spine J
January 2025
Texas Back Institute Research Foundation, Plano, TX, USA.
Purpose: The purpose of this study was to investigate the outcomes of minimally invasive PCF using an interfacet joint fusion cage.
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Eur Spine J
January 2025
Fundación Valle del Lili, Santiago de Cali, Colombia.
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J Pak Med Assoc
January 2025
Quetta Institute of Medical Sciences, Quetta, Pakistan.
The objective of this mini review is to discuss the role of musculoskeletal ultrasound (MSK US) in identification and treatment of pain generators in cervical spine in patients presenting with cervicogenic headache (CEH). CEH is a secondary headache arising from cervical nociceptive structures emerging from facet joints, intervertebral discs, nerves, muscles, fascia and ligaments. It presents a complex challenge in clinical management.
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