Abstract
Background Diagnosis of intervertebral disc degeneration (IVDD) is challenging at the early stage. The cartilage oligomeric matrix protein (COMP) and extracellular matrix degradation products of C-telopeptide of type II collagen (CTX-II) serve as markers for the serological diagnosis of IVDD. Oxidative stress might cause IVDD and matrix degeneration. Methods A total of 128 male adult Sprague–Dawley (SD) rats were randomly and equally assigned to the experimental and control groups. The experimental group was used to construct IVDD models by acupuncture, while the control group underwent sham operation. The animals were executed every week for 8 weeks after intervertebral disc acupuncture, and serum samples were collected for the estimation of CTX-II and COMP concentrations by enzyme-linked immunosorbent assay (ELISA). Also, the histological changes and caudal magnetic resonance imaging (MRI) changes were examined in the intervertebral disc. Results IVDD in rats worsened with prolonged follow-up after acupuncture. At all the time points, the experimental group showed altered histological and caudal vertebra MRI signals, and serum CTX-II and COMP concentrations were significantly greater than those of the control group. These levels increase with the process of IVDD. Conclusion Serum CTX-II and COMP estimation is a reliable method to diagnose IVDD, and their concentrations show a positive correlation with the process of IVDD.
Highlights
Diagnosis of intervertebral disc degeneration (IVDD) is challenging at the early stage
The findings showed that the degeneration of the acupunctured segment in the rat worsened over time; the severity of IVDD increased; the nucleus pulposus (NP) structure changed from a uniform and bright white to uneven and black; the boundary between NPC and annulus fiber disappeared; the magnetic resonance imaging (MRI) T2 phase changed from high signal to low signal, and the height of the intervertebral disc decreased progressively (Figure 2)
The control group showed intact NPCs in the intervertebral disc: a quasicircular central NPC, a large number of notochord cells, a small number of chondroid cells, and the peripheral annulus fibrosus arranged in an annular manner with a distinct boundary with the NPCs
Summary
Diagnosis of intervertebral disc degeneration (IVDD) is challenging at the early stage. At all the time points, the experimental group showed altered histological and caudal vertebra MRI signals, and serum CTX-II and COMP concentrations were significantly greater than those of the control group. These levels increase with the process of IVDD. The lifetime prevalence of neck and lower back pain is 84%, resulting in disability in 11-12% of patients. The impact of this disability on the medical industry is increasing, with a sharp increase in treatment costs every year. The medical expense on neck and lower back pain exceeds USD 200 billion every year [3, 4]
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