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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Brismée 2009.

Immunohistochemical and histological study of human uncovertebral joints: a preliminary investigation

updated
Brismée JM, Sizer J, Dedrick GS, Sawyer BG, Smith MP. Immunohistochemical and histological study of human uncovertebral joints: a preliminary investigation. Spine (Phila Pa 1976). 2009 May;34(12):1257–63. PubMed #19455000.
Tags: neck, neat, etiology, anatomy, head/neck, spine, pro

PainSci summary of Brismée 2009?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

This is quite a technical paper about some special joints unique to the cervical spine: unconvertebral joints (AKA Luschka’s joints or neurocentral joints). It suggests “that the structure is synovial in nature” and that “the uncovertebral joints are potential pain generators in the cervical spine.”

Basically, an uncovertebral joint consists of small overlapping lips of bone extending from the top and bottom edges of vertebral bodies. It’s a strange, maybe-a-synovial-joint-and-maybe-not structure so obscure that it barely has a Wikipedia page. And yet arthritic overgrowth at this joint may be one of the most common causes of pinched cervical nerve roots (or even the spinal cord)

~ Paul Ingraham

original abstract

STUDY DESIGN: A descriptive cadaveric study.

OBJECTIVE: To investigate the anatomy and innervation of the uncovertebral joint to determine if it is synovial in nature and capable of generating pain.

SUMMARY OF BACKGROUND DATA: There is controversy with regard to the anatomic and histological makeup of the uncovertebral interface with some authors considering it a joint and others disc tissue. No research has investigated the presence of pain generating neurotransmitters within the uncovertebral cartilaginous and capsular tissue.

METHODS: Tissue from uncovertebral capsule and cartilage was harvested for each uncovertebral surface starting at the C2-C3 to the C6-C7 cervical segment. The tissue was placed in 4% paraformaldehyde fixative, then dehydrated and embedded in paraffin. Ten micron sections were cut through the tissue blocks and mounted on slides. The tissue was rehydrated and either stained with hematoxylin and eosin (H and E) or immunostained with antisera against protein gene product 9.5 (PGP 9.5), substance P (SP), neuropeptide Y (NPY), and calcitonin gene-related peptide (CGRP).

RESULTS: The sample consisted of 2 unembalmed fresh male human cadavers of a mean age of 83 years. Chondrocytes and synoviocytes were identified at the capsular tissue of each uncovertebral interface from C2-C3-C6-C7. Immunoreactivity for PGP 9.5, SP, CGRP, and NPY was observed at all uncovertebral interface levels in capsular tissue.

CONCLUSION: The presence of both synoviocytes and chondrocytes has been recorded in the present study, suggesting that the uncovertebral interface is synovial in nature. Immunoreactivity to PGP 9.5, SP, CGRP, and NPY indicates the presence of nerve fibers from both the somatic and autonomic nervous systems. These findings suggest that the uncovertebral joints are potential pain generators in the cervical spine.

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