scholarly journals Inflammatory Serum Protein Profiling of Patients with Lumbar Radicular Pain One Year after Disc Herniation

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Aurora Moen ◽  
Anne-Li Lind ◽  
Måns Thulin ◽  
Masood Kamali-Moghaddam ◽  
Cecilie Røe ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Serum Proteins ◽  
Protein Profile ◽  
Radicular Pain ◽  
Protein Profiling ◽  
University Hospital ◽  
Serum Profiling ◽  
Inflammatory Protein ◽  
Lumbar Radicular Pain ◽  
One Year

Earlier studies suggest that lumbar radicular pain following disc herniation may be associated with a local or systemic inflammatory process. In the present study, we investigated the serum inflammatory protein profile of such patients. All 45 patients were recruited from Oslo University Hospital, Ullevål, Norway, during the period 2007–2009. The new multiplex proximity extension assay (PEA) technology was used to analyze the levels of 92 proteins. Interestingly, the present data showed that patients with radicular pain 12 months after disc herniation may be different from other patients with regard to many measurable serum cytokines. Given a false discovery rate (FDR) of 0.10 and 0.05, we identified 41 and 13 proteins, respectively, which were significantly upregulated in the patients with severe pain one year after disc herniation. On the top of the list ranked by estimated increase we found C-X-C motif chemokine 5 (CXCM5; 217% increase), epidermal growth factor (EGF; 142% increase), and monocyte chemotactic protein 4 (MCP-4; 70% increase). Moreover, a clear overall difference in the serum cytokine profile between the chronic and the recovered patients was demonstrated. Thus, the present results may be important for future protein serum profiling of lumbar radicular pain patients with regard to prognosis and choice of treatment. We conclude that serum proteins may be measurable molecular markers of persistent pain after disc herniation.

The interleukin-1α gene C>T polymorphism rs1800587 is associated with increased pain intensity and decreased pressure pain thresholds in patients with lumbar radicular pain

2014 ◽  
Vol 5 (3) ◽  
pp. 212-212
Author(s):  
Elina Iordanova Schistad ◽  
Line Melå Jacobsen ◽  
Cecilie Røe ◽  
Johannes Gjerstad
Keyword(s):  
Pain Intensity ◽  
Disc Herniation ◽  
Pressure Pain Threshold ◽  
Radicular Pain ◽  
University Hospital ◽  
Repeated Measure ◽  
Taqman Assay ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Lumbar Radicular Pain

Abstract Aims Previous studies have suggested that many inflammatory cytokines, including interleukin (IL)-1α, may be associated with lumbar radicular pain after disc herniation. In the present study, we examined how variability of the IL-1α gene affects pain intensity and the pressure pain threshold (PPT) in patients with symptomatic disc herniation. Methods A total of 121 patients with lumbar radicular pain due to disc herniation were recruited from Oslo University Hospital, Norway, and followed up at 6 weeks and 12 months. The primary outcome measures were pain intensity scores for the lower back and legs using a visual analog pain scale (VAS) and PPT for the gluteal muscles. Genotyping was carried out using a predesigned TaqMan assay for IL-1α rs1800587. The effect of the IL-1α genotype on the VAS and PPT was analyzed by repeated measure analyses of variance. Results The IL-1α gene C>T polymorphism rs1800587 affected VAS and PPT scores in patients with symptomatic disc herniation. Patients with the CT/TT genotype reported a higher VAS leg pain intensity (p = 0.002) and also a lower PPT in the gluteal muscles (left p = 0.016; right p = 0.016) compared to patients with the CC genotype during 1 year of follow-up. Conclusions The present data show that the IL-1α CT/TT genotype rs1800587 may be associated with increased pain intensity, and corresponding reduced PPT during the first year after disc herniation.

scholarly journals Role of IL1A rs1800587, IL1B rs1143627 and IL1RN rs2234677 Genotype Regarding Development of Chronic Lumbar Radicular Pain; a Prospective One-Year Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e107301 ◽  
Author(s):  
Aurora Moen ◽  
Elina Iordanova Schistad ◽  
Lars Jørgen Rygh ◽  
Cecilie Røe ◽  
Johannes Gjerstad
Keyword(s):  
Radicular Pain ◽  
Lumbar Radicular Pain ◽  
One Year

Microsurgical Excision of Herniated Lumber Disc in Pediatric Population

2018 ◽  
Vol 2 (3) ◽  
pp. 01-05
Author(s):  
Ahmed Zaher
Keyword(s):  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Pediatric Population ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
University Hospital ◽  
Csf Leak ◽  
Degree Relative ◽  
History Of

Lumbar disc herniation is a relatively rare disorder among children and adolescent population compared to adults. The objectives of this work are to study the lumbar disc herniation in pediatric population and determine the surgical outcome of lumbar microdiscectomy in such population. Patients and methods: A series of 32 pediatric patients less than 18 years operated by microdiscectomy at Mansoura University hospital during the period from January 2005 to March 2015 were retrospectively analyzed. Clinical presentation, physical signs, predisposing factors, radiological investigations and operative findings were retrieved from medical records. Improvement of pain was assessed by visual analogue scale. Results: The study included 17 females (53.1%) and 15 males (46.9%) ranging in age from 10 to18 years (mean, 14.2 year). The patients were followed up for periods ranging from three to 115 months (mean, 55 months). All patients had radicular pain (100%) with additional back pain in twenty one patients (65.63%), twenty eight patients (87.5%) presented by sciatic pain while six patients (18.75%) showed femoral neuralgia. Straight leg raising test was positive in 90.62%. L4/5 was the commonest affected level in eighteen patients (56.25%) while twelve patients (37.5%) had disc herniation at L5-S1 level and only two patients had herniation at L3-4 disc level. Family history of lumbar disc herniation in first degree relative was positive in twenty one patients (65.63%). History of relevant trauma was documented in only twelve patients (37.5%). During surgery the disc was soft, rubbery and well hydrated in 90.6% of cases. Subligamentous disc herniation was observed in 81%, while 12.5% of patients had disc bulge with intact annulus and only 6.5% had extruded disc. All patients showed significant improvement of radicular pain at the time of discharge while back pain continued to improve during early postoperative follow up. Low back pain and radicular pain equally improved after three months despite instant postoperative improvement of radicular pain. Postoperative complications were rare and included one case of wound infection, one case of iatrogenic CSF leak and new neurological deficit in another case. Conclusion: Lumbar disc herniation in pediatric population differs from that of adults in many aspects. Microdiscectomy is safe and reliable procedure for management of pediatric lumbar disc herniation with good outcome and minimal morbidity

Repeat epidural steroid injections for radicular pain due to lumbar or cervical disc herniation

2018 ◽  
Vol 100-B (10) ◽  
pp. 1364-1371 ◽  
Author(s):  
H. Joswig ◽  
A. Neff ◽  
C. Ruppert ◽  
G. Hildebrandt ◽  
M. N. Stienen
Keyword(s):  
Functional Outcome ◽  
Disc Herniation ◽  
Radicular Pain ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Arm Pain ◽  
One Year ◽  
Epidural Steroid

AimsThe aim of this study was to determine the efficacy of repeat epidural steroid injections as a form of treatment for patients with insufficiently controlled or recurrent radicular pain due to a lumbar or cervical disc herniation.Patients and MethodsA cohort of 102 patients was prospectively followed, after an epidural steroid injection for radicular symptoms due to lumbar disc herniation, in 57 patients, and cervical disc herniation, in 45 patients. Those patients with persistent pain who requested a second injection were prospectively followed for one year. Radicular and local pain were assessed on a visual analogue scale (VAS), functional outcome with the Oswestry Disability Index (ODI) or the Neck Pain and Disability Index (NPAD), as well as health-related quality of life (HRQoL) using the 12-Item Short-Form Health Survey questionnaire (SF-12).ResultsA second injection was performed in 17 patients (29.8%) with lumbar herniation and seven (15.6%) with cervical herniation at a mean of 65.3 days (sd 46.5) and 47 days (sd 37.2), respectively, after the initial injection. All but one patient, who underwent lumbar microdiscectomy, responded satisfactorily with a mean VAS for leg pain of 8.8 mm (sd 10.3) and a mean VAS for arm pain of 6.3 mm (sd 9) one year after the second injection, respectively. Similarly, functional outcome and HRQoL were improved significantly from the baseline scores: mean ODI, 12.3 (sd 12.4; p < 0.001); mean NPAD, 19.3 (sd 24.3; p = 0.041); mean SF-12 physical component summary (PCS) in lumbar herniation, 46.8 (sd 7.7; p < 0.001); mean SF-12 PCS in cervical herniation, 43 (sd 6.8; p = 0.103).ConclusionRepeat steroid injections are a justifiable form of treatment in symptomatic patients with lumbar or cervical disc herniation whose symptoms are not satisfactorily relieved after the first injection. Cite this article: Bone Joint J 2018;100-B:1364–71.

scholarly journals Endoscopic Epidural Laser Decompression Versus Transforaminal Epiduroscopic Laser Annuloplasty for Lumbar Disc Herniation: A Prospective, Randomized Trial

2017 ◽  
Vol 7 (20;7) ◽  
pp. 633-670
Author(s):  
Chang Hong Park
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Secondary Outcome ◽  
Pain Scores ◽  
Number Of Patients ◽  
The Mean ◽  
Lumbar Radicular Pain

Background: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleoannuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. Objective: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation. Study Design: A randomized, prospective trial. Setting: The Department of Anesthesiology and Pain Medicine at Spine Health Wooridul Hospital in Daegu, Korea. Methods: A total of 97 patients were enrolled in this study; 48 patients underwent EELD and 49 underwent TELA. The pain relief was evaluated at baseline and at 1, 3, and 6 months post-procedure via the numeric rating scale (NRS). The Oswestry Disability Index (ODI) was recorded at baseline and at the final follow-up. Postoperative wound pain was assessed over a 24-hour period. Complications and side effects were also recorded, as were operative times (from local anesthetic infiltration at entry sites to suturing of skin). Results: At post-treatment months 1, 3, and 6 the mean pain scores of patients were significantly lower (relative to pre-treatment baseline) regardless of the procedure used. However, the mean pain scores did not differ significantly by procedure (EELD vs TELA). As well, the number of patients who obtained relief from their pain and needed analgesics was not statistically significant. The irrigation volume was significantly higher in the TELA group. Two patients undergoing TELA procedures experienced headache during the procedures; however, no serious complications such as bleeding, dural/neural injuries, or infection were recorded for either group. Limitation: The observed significant reductions in pain (from baseline) lacked secondary outcome substantiation and given the mid follow-up period, no long-term follow-up results were monitored. Conclusion: Both EELD and TELA provide similar outcomes and are reasonable treatment options for carefully selected patients with lower back or radicular pain. Key words: Epiduroscopy, laser, annuloplasty, disc, herniation, TELA

scholarly journals Protectin DX Attenuates Lumbar Radicular Pain of Non-compressive Disc Herniation by Autophagy Flux Stimulation via Adenosine Monophosphate-Activated Protein Kinase Signaling

2022 ◽  
Vol 12 ◽  
Author(s):  
Qing-xiang Zhao ◽  
Yi-hao Wang ◽  
Si-cong Wang ◽  
Song Xue ◽  
Zhen-xin Cao ◽  
...  
Keyword(s):  
Protein Kinase ◽  
Disc Herniation ◽  
Adenosine Monophosphate ◽  
Radicular Pain ◽  
Autophagy Flux ◽  
Rat Models ◽  
Ampk Signaling ◽  
Analgesic Effects ◽  
Lumbar Radicular Pain ◽  
Protectin Dx

Background: Neuroinflammation plays a crucial role in initiating and sustaining lumbar radicular pain (LRP). Protectin DX (PDX) has been experimentally verified to possess pro-resolving properties and anti-inflammatory effects. This study aimed to observe the analgesic effects of PDX and its potential mechanisms in LRP rats with non-compressive lumbar disc herniation (NCLDH).Method: Only male rats were selected to avoid gender-related interferences. Rat models of NCLDH were established, and rats were randomly divided into four groups: the sham group, the vehicle group, the PDX (10 ng PDX) group, and the PDX (100 ng PDX) group. Changes in the mechanical withdrawal threshold and thermal withdrawal latency were observed for 7 days. The mRNAs of pro-inflammatory and anti-inflammatory mediators were evaluated via real-time polymerase chain reaction, whereas western blot and immunohistochemistry were separately conducted to assess the expression levels of autophagy-related proteins and adenosine monophosphate-activated protein kinase (AMPK) signaling.Results: Intrathecal delivery of PDX reduced interleukin (IL)-6 and IL-1β mRNA levels and facilitated mRNA transcription of transforming growth factor-β1, with attenuation of mechanical and thermal hyperalgesia in LRP rat models. With the application of nucleus pulposus to the dorsal root ganglion, autophagy flux and AMPK signaling were severely disrupted in the spinal dorsal horns, and intrathecal treatment with PDX could dose-dependently restore the dysfunction of autophagy flux and AMPK signaling.Conclusion: These data suggest that PDX possesses pro-resolving properties and exerts potent analgesic effects in LRP by affecting autophagy flux via AMPK signaling.

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