Correlation between inflammatory cytokines released from the lumbar facet joint tissue and symptoms in degenerative lumbar spinal disorders
Correlation between inflammatory cytokines released from the lumbar facet joint tissue and symptoms in degenerative lumbar spinal disorders
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DOI：
10.1007/s00776-006-1105-y
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发表时间：
2007-03-01
影响因子：
1.7
通讯作者：
Konno, Shin-ichi
中科院分区：
文献类型：
--
作者：
Igarashi, Akira;Kikuchi, Shin-ichi;Konno, Shin-ichi
背景腰椎小关节组织具有炎性细胞因子。然而，没有报道表明小关节中的炎性细胞因子是否导致疼痛。本研究旨在描述退行性腰椎疾病中小关节组织释放的炎性细胞因子与症状之间的相关性。本研究的目的是通过临床和解剖学研究，寻找腰椎管狭窄症神经根病变累及小关节炎的可能性。本文对40例腰椎后路手术患者的腰椎小关节软骨和滑膜组织进行了肿瘤坏死因子α（TNF α）、白细胞介素1 β（IL 1 β）和白细胞介素6（IL 6）的测定。采用视觉模拟评分（VAS）和Roland-Morris功能障碍问卷（RDQ）检测细胞因子浓度与症状的相关性。将着色剂注入新鲜尸体的小关节内，观察色素从小关节渗漏到椎管内的情况。腰椎管狭窄症（LSCS）组和腰椎间盘突出症（LDH）组关节组织中均检测到炎性细胞因子。LSCS组IL-1 β阳性率明显高于LDH组。LSCS组中IL-1 β阳性病例显示出较高的腿部疼痛VAS评分和较高的RDQ评分。椎管内包括腰神经根的组织用美蓝小关节内注射法染色。LSCS小关节软骨中的IL-1 β与下肢疼痛和生活质量下降相关。退变的小关节产生的炎性细胞因子可通过腹侧小关节囊的外侧部分渗漏到椎管内。这些结果表明，炎症细胞因子参与退行性腰椎小关节疼痛的发生。
Background. Lumbar facet joint tissue has inflammatory cytokines. However, no reports have shown whether inflammatory cytokines in the facet joint leads to pain. This study was designed to characterize the correlation between inflammatory cytokines released from facet joint tissue and symptoms in degenerative lumbar spinal disorders. The purpose of this study was to seek involvement of inflammatory facet joint for radiculopathy in lumbar spinal canal stenosis with clinical and anatomical studies.Methods. Lumbar facet joint cartilage and synovial tissues in 40 cases of posterior lumbar surgery were harvested to measure tumor necrotizing factor-alpha (TNF alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) during operation. The visual analogue scale (VAS) and Roland-Morris disability questionnaire (RDQ) were used to examine the correlation between cytokine concentration and symptoms. Coloring agent was injected into facet joints of fresh cadavers to find leakage of pigment from the facet joint into the spinal canal.Results. Inflammatory cytokines were detected in the joint tissues in the lumbar spinal canal stenosis (LSCS) and lumbar disc herniation (LDH) groups. A positive reaction rate of IL-1 beta was significantly higher in the LSCS group than in the LDH group. IL-1 beta-positive cases in the LSCS group showed higher VAS scores for leg pain and higher RDQ scores. Intraspinal canal tissues including lumbar nerve root were stained by injection of methylene blue into the facet joints.Conclusions. IL-1 beta in facet joint cartilage in LSCS was associated with leg pain and a decline of quality of life. Inflammatory cytokines produced in degenerated facet joint may leak into the intraspinal space through the lateral part of the ventral facet joint capsule. These results suggest the involvement of inflammatory cytokines in degenerated lumbar facet joints regarding the genesis of pain production.