METABOLIC CHANGES IN THE CEREBROSPINAL FLUID OF PATIENTS WITH SPINAL DEGENERATIVE DISOEDERS

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The cerebrospinal fluid (CSF) samples were obtained by lumbar puncture from patients with cervical myelopathy (Group M), lumbar radiculopathy (Group R) prior to myelography, and 10 volunteers (control). Using high resolution nuclear magnetic resonance (NMR) spectroscopy, lactate, alanine, acetate, glutamate, pyruvate, and citrate concentrations in CSF were measured. Also the concentrations of interleukin 1 beta (IL-1-beta), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) in CSF were measured. In Groups M and R, we evaluated the differences in the above-mentioned metabolites and cytokines with in control. Moreover, the relationships between each metabolite or cytokine and the severity of these disorders or symptom duration were evaluated. The severity of diseases was scored using Japanese Orthopedic Association (JOA) score for cervical myelopathy in Group M or JOA score for lumbar disorders in Group B. In Group B we also evaluated the relationship between each metabolite or cytokine and the duration of the relief from radiculopathy after a root block.In Group M, none of cytokines or metabolites was not significantly difference compared to control. Each metabolite or cytokine demonstrated no significant relationship with the symptom duration or JOA score. In Group R, IL-6 was significantly higher, and citrate was significantly lower than in control. Lactate, glutamate, and citrate had significantly positive relationship with symptom duration. TNF-alpha demonstrated significantly positive relationship and pyruvate had significantly negative relationship with duration of the relief from radiculopathy after root block.Our data suggested increased aerobic metabolism was shown in the patient with lumbar radiculopathy.