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Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo

Yang, Liang MD†,‡; Yang, Cheng MD, PhD§; Pang, Xiaodong MD, PhD; Li, Duanming MD; Yang, Hong MD; Zhang, Xinwu MD; Yang, Yi MD||; Peng, Baogan MD, PhD

doi: 10.1097/BRS.0000000000001801

Study Design. We collected the samples of cervical intervertebral discs from patients with vertigo to examine the distribution and types of mechanoreceptors in diseased cervical disc.

Objective. The aim of this study was to determine whether mechanoreceptors are distributed more abundantly in cervical discs from patients with cervical spondylosis, and whether they are related to vertigo.

Summary of Background Data. Previous limited studies have found that normal cervical intervertebral discs are supplied with mechanoreceptors that have been considered responsible for proprioceptive functions. Several clinical studies have indicated that the patients with cervical spondylosis manifested significantly impaired postural control and subjective balance disturbance.

Methods. We collected 77 samples of cervical discs from 62 cervical spondylosis patients without vertigo, 61 samples from 54 patients with vertigo, and 40 control samples from 8 cadaveric donors to investigate distribution of mechanoreceptors containing neurofilament (NF200) and S-100 protein immunoreactive nerve endings.

Results. The immunohistochemical investigation revealed that the most frequently encountered mechanoreceptors were the Ruffini corpuscles in all groups of cervical disc samples. They were obviously increased in the number and deeply ingrown into inner annulus fibrosus and even into nucleus pulposus in the diseased cervical discs from patients with vertigo in comparison with the discs from patients without vertigo and control discs. Only three Golgi endings were seen in the three samples from patients with vertigo. No Pacinian corpuscles were found in any samples of cervical discs.

Conclusion. The diseased cervical discs from patients with vertigo had more abundant distribution of Ruffini corpuscles than other discs. A positive association between the increased number and ingrowth of Ruffini corpuscles in the diseased cervical disc and the incidence of vertigo in the patients with cervical spondylosis was found, which may indicate a key role of Ruffini corpuscles in the pathogenesis of vertigo of cervical origin.

Level of Evidence: 1

Department of Spinal Surgery, General Hospital of Armed Police Force, Beijing, China

Department of Orthopeadics, Xijing Hospital, The Fourth Military Medical University, Xi’an, China

Department of Orthopedics, Pingjin Hospital, Logistics College of Armed Police Forces, Tianjin, China

§Department of Orthopeadics, Changzheng Hospital, Shanghai, China

Department of Pathology, General Hospital of Armed Police Force, Beijing, China

||Department of Pathology, 304th Hospital, Beijing, China.

Address correspondence and reprint requests to Baogan Peng, MD, PhD, Professor, Department of Spinal Surgery, Institute of Spinal Surgery of Armed Police Force, General Hospital of Armed Police Force, 69 Yongding Road, Beijing 100039, P.R. China. E-mail:

Received 1 June, 2016

Revised 27 June, 2016

Accepted 5 July, 2016

The manuscript submitted does not contain information about medical device(s)/drug(s).

L. Yang and C. Yang contributed equally to this study.

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved