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

脑脊液标本取自脊髓型颈椎病患者(M组)、腰神经根病患者(R组)及10例健康志愿者(对照组)。使用高分辨率核磁共振(核磁共振)谱检测脑脊液中乳酸、丙氨酸、醋酸盐、谷氨酸、丙酮酸和柠檬酸的浓度。同时检测脑脊液中白介素1-β(IL-1-β)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)的浓度。M组和R组与正常对照组比较上述代谢物和细胞因子的差异。此外，每种代谢物或细胞因子与这些疾病的严重程度或症状持续时间之间的关系也被评估。用日本骨科学会(JOA)对M组的颈椎病和B组的腰椎疾患的JOA评分进行病情严重程度评分，并评价B组中各代谢物或细胞因子与根管封闭后神经根病变缓解时间的关系。每种代谢物或细胞因子与症状持续时间或JOA评分没有显著关系。R组IL-6水平显著高于对照组，柠檬酸水平显著低于对照组。乳酸、谷氨酸、柠檬酸与症状持续时间呈显著正相关。肿瘤坏死因子α与神经根封闭后缓解时间呈显著正相关，丙酮酸与神经根病变缓解时间呈显著负相关，提示腰神经根病患者有氧代谢增强。

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.