Universität zu Köln

Andrade, Pablo ORCID: 0000-0002-2596-7301, Hoogland, Govert, Teernstra, Onno P., van Aalst, Jasper, van Maren, Emiel, Daemen, Marc A. and Visser-Vandewalle, Veerle (2016). Elevated levels of tumor necrosis factor-alpha and TNFR1 in recurrent herniated lumbar discs correlate with chronicity of postoperative sciatic pain. Spine Journal, 16 (2). S. 243 - 252. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-1632

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Abstract

BACKGROUND CONTEXT: Sciatica is a condition characterized by radicular pain that can be secondary to a lumbar disc herniation (LDH). More than 10% of patients report persistent pain after surgery. The underlying mechanisms of postoperative sciatica remain unclear. There is evidence demonstrating that inflammation plays a role in the pathophysiology of sciatica. PURPOSE: The study aimed to assess if the expression of tumor necrosis factor (TNF)-alpha and its receptors (TNFR) was correlated with the severity of pre- and postoperative leg pain in LDH patients who underwent single or multiple decompressive discectomies. SETTING: This is an experimental prospective human study of intraoperative intervertebral disc (IVD) samples, as well as a clinical scores evaluation. METHODS: We analyzed the mRNA and protein levels of TNF-alpha, TNFR1, and TNFR2 in IVD biopsies, and correlated them with visual analogue scale (VAS) scores 1 day before surgery to 6 weeks and 6 months postoperatively. RESULTS: We evaluated the correlation between the inflammation in IVD with pre- and postoperative pain scores after discectomy in LDH patients operated for the first time (fLDH, N=12) and for recurrent cases (rLDH, N=8). This analysis showed that TNF-alpha and TNFR1 mRNA levels were significantly greater in rLDH patients; there was a twofold increase for TNF-alpha and a 50% increase for TNFR1. Similarly, protein levels in IVD samples positively correlated with postoperative VAS scores, whereas TNFR2 protein levels negatively correlated with postoperative VAS scores. CONCLUSIONS: These findings indicate that rLDH patients present higher postoperative VAS scores compared with fLDH patients, and also that these scores are correlated with increased inflammation and may contribute to pain chronicity. (C) 2015 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Andrade, Pablo UNSPECIFIED orcid.org/0000-0002-2596-7301 UNSPECIFIED Hoogland, Govert UNSPECIFIED UNSPECIFIED UNSPECIFIED Teernstra, Onno P. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Aalst, Jasper UNSPECIFIED UNSPECIFIED UNSPECIFIED van Maren, Emiel UNSPECIFIED UNSPECIFIED UNSPECIFIED Daemen, Marc A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-286719
DOI:	10.1016/j.spinee.2015.10.038
Journal or Publication Title:	Spine Journal
Volume:	16
Number:	2
Page Range:	S. 243 - 252
Date:	2016
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-1632
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DORSAL-ROOT GANGLIA; RAT SPINAL-CORD; NEUROPATHIC PAIN; INFLAMMATORY CYTOKINES; INTERVERTEBRAL DISCS; NITRIC-OXIDE; BACK-PAIN; EXPRESSION; RECEPTOR; MODEL Multiple languages Clinical Neurology; Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28671