TY - JOUR

T1 - Low back pain scores correlate with the cytokine mRNA level in lumbar disc biopsies

T2 - a study of inflammatory markers in patients undergoing lumbar spinal fusion

AU - Aripaka, Sanjay S.

AU - Bech-Azeddine, R.

AU - Jørgensen, L. M.

AU - Chughtai, S. A.

AU - Gaarde, C.

AU - Bendix, T.

AU - Mikkelsen, J. D.

PY - 2021

Y1 - 2021

N2 - Purpose The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD). Methods Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63]. The mRNA expression of TNF-alpha, IL-1 beta, and IL-6 in the AF and NP was analyzed using quantitative real-time polymerase chain reaction (RT-qPCR), and the expression level of these markers was correlated to the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores (0-100) for pain and disability. Results We report a statistically significant positive correlation between pain intensity (VAS score) and the expression of TNF-alpha in both the AF (r = 0.54, p = 0.001) and NP (r = 0.40, p = 0.02), similarly with IL-1 beta in AF (r = 0.37, p = 0.02) and IL-6 in NP (r = 0.40, p = 0.02). In addition, we found significant positive correlation observed between disability score (ODI) and expression of IL-6 in both AF (r = 0.36, p = 0.03) and NP (r = 0.41, p = 0.01). Conclusion We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.

AB - Purpose The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD). Methods Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63]. The mRNA expression of TNF-alpha, IL-1 beta, and IL-6 in the AF and NP was analyzed using quantitative real-time polymerase chain reaction (RT-qPCR), and the expression level of these markers was correlated to the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores (0-100) for pain and disability. Results We report a statistically significant positive correlation between pain intensity (VAS score) and the expression of TNF-alpha in both the AF (r = 0.54, p = 0.001) and NP (r = 0.40, p = 0.02), similarly with IL-1 beta in AF (r = 0.37, p = 0.02) and IL-6 in NP (r = 0.40, p = 0.02). In addition, we found significant positive correlation observed between disability score (ODI) and expression of IL-6 in both AF (r = 0.36, p = 0.03) and NP (r = 0.41, p = 0.01). Conclusion We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.

KW - Intervertebral disc

KW - Low back pain

KW - Degenerative disc

KW - VAS score

KW - TNF-&#945

KW - INTERVERTEBRAL DISC

KW - TNF-ALPHA

KW - PROINFLAMMATORY CYTOKINE

KW - DEGENERATIVE CHANGES

U2 - 10.1007/s00586-021-06868-3

DO - 10.1007/s00586-021-06868-3

M3 - Journal article

C2 - 34023967

VL - 30

SP - 2967

EP - 2974

JO - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

ER -