Correlation between nerve root pain and expression of TNF-α, PGE2, PLA2 in nucleus pulposus of lumbar intervertebral disc herniation

Abstract

Objective To explore the correlation between nerve root pain and the expression of tumor necrosis factor-alpha (TNF-α) , prostaglandin E2 (PGE2) , phospholipase A2 (PLA2) in nucleus pulposus of patients with lumbar intervertebral disc herniation. Methods Seventy-eight patients with lumbar intervertebral disc herniation were selected as the study subjects. According to the extent of the nucleus pulposus herniation, patients were divided into three groups, the free type, the prominent type and the bulging type, 26 cases in each group. Sixty patients of lumbar fracture surgery without lumbar intervertebral disc herniation were taken as control group. The expression of TNF-α, PGE2 and PLA2 were detected by enzyme immunoassay. The correlation between the expression of TNF-α, PGE2, PLA2 and VAS was analyzed by Person linear. Results The expression of PLA2, PGE2 and TNF-α in the nucleus pulposus of three groups with different types of lumbar intervertebral disc herniation were significantly higher than those in the control group (P<0.05) . The expression of TNF-α, PGE2, PLA2 was higher in the free type group than that in the prominent type and bulging type groups, and higher in the prominent type group than that in the bulging type group (P<0.05) . The expression of TNF-α, PGE2 and PLA2 was the independent risk factor for the nerve root pain (P<0.05) .The expression of TNF-α, PGE2 and PLA2 was positively correlated with VAS (r=0.726, P=0.003; r=0.863, P=0.012; r=0.749, P=0.023) respectively. Conclusion The expression of TNF-α, PGE2 and PLA2 in nucleus pulposus involves in the process of lumbar disc degeneration, with positively correlation with VAS. Key words: Lumbar intervertebral disc herniation; Nucleus pulposus; Tumor necrosis factor-alpha; Phospholipases A2; Prostaglandin E2; Nerve root pain