Intervertebral Disk Lesions Are the Most Common Cause of Low Back Pain With or Without Sciatica

Key, J. Albert; Louis, St.

doi:10.1097/00000658-194504000-00013

Cited by 27 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since the first report of spontaneous LDH regression [ 4 ] and of computed tomography (CT)-confirmed spontaneous LDH regression [ 5 ], documentation of this phenomenon has become broadly available in the literature. Imaging diagnostic tools such as magnetic resonance imaging (MRI) have a central role in confirming LDH regression and, although controversial for a significant number of years, it is now widely recognized that large-sized and sequestrated LDH tend to regress more than other LDH subtypes (Fig.…”

Section: Clinical Evidence Of Spontaneous Ldh Regressionmentioning

confidence: 99%

The inflammatory response in the regression of lumbar disc herniation

et al. 2018

View full text Add to dashboard Cite

Lumbar disc herniation (LDH) is highly associated with inflammation in the context of low back pain. Currently, inflammation is associated with adverse symptoms related to the stimulation of nerve fibers that may lead to pain. However, inflammation has also been indicated as the main factor responsible for LDH regression. This apparent controversy places inflammation as a good prognostic indicator of spontaneous regression of LDH. This review addresses the molecular and cellular mechanisms involved in LDH regression, including matrix remodeling and neovascularization, in the scope of the clinical decision on conservative versus surgical intervention. Based on the evidence, a special focus on the inflammatory response in the LDH context is given, particularly in the monocyte/macrophage role. The phenomenon of spontaneous regression of LDH, extensively reported in the literature, is therefore analyzed here under the perspective of the modulatory role of inflammation.

show abstract

Section: Clinical Evidence Of Spontaneous Ldh Regressionmentioning

confidence: 99%

The inflammatory response in the regression of lumbar disc herniation

et al. 2018

View full text Add to dashboard Cite

show abstract

“…However, in IVD prolapse, which can occur independently (as a result of exceeding the physiological limit of flexion or compressive force through a motion segment [ 20 , 21 ], or as a secondary complication of IVD degeneration [ 22 ], locally produced cytokines may form part of the mechanism of spontaneous resorption. The spontaneous resorption of prolapsed lumbar IVD tissue has frequently been observed [ 23 - 25 ] although the exact mechanisms by which this occur are not yet fully understood. Inflammatory and autoimmune responses provoked in the innate and adaptive immune systems on detection of displaced tissue likely play a role, with infiltrating monocytes [ 26 ], macrophages [ 26 - 29 ], T and B lymphocytes [ 27 , 28 ] and fibroblasts [ 29 ] reported in prolapsed NP tissue.…”

Section: Introductionmentioning

confidence: 99%

The cytokine and chemokine expression profile of nucleus pulposus cells: implications for degeneration and regeneration of the intervertebral disc

et al. 2013

View full text Add to dashboard Cite

IntroductionThe aims of these studies were to identify the cytokine and chemokine expression profile of nucleus pulposus (NP) cells and to determine the relationships between NP cell cytokine and chemokine production and the characteristic tissue changes seen during intervertebral disc (IVD) degeneration.MethodsReal-time q-PCR cDNA Low Density Array (LDA) was used to investigate the expression of 91 cytokine and chemokine associated genes in NP cells from degenerate human IVDs. Further real-time q-PCR was used to investigate 30 selected cytokine and chemokine associated genes in NP cells from non-degenerate and degenerate IVDs and those from IVDs with immune cell infiltrates (‘infiltrated’). Immunohistochemistry (IHC) was performed for four selected cytokines and chemokines to confirm and localize protein expression in human NP tissue samples.ResultsLDA identified the expression of numerous cytokine and chemokine associated genes including 15 novel cytokines and chemokines. Further q-PCR gene expression studies identified differential expression patterns in NP cells derived from non-degenerate, degenerate and infiltrated IVDs. IHC confirmed NP cells as a source of IL-16, CCL2, CCL7 and CXCL8 and that protein expression of CCL2, CCL7 and CXCL8 increases concordant with histological degenerative tissue changes.ConclusionsOur data indicates that NP cells are a source of cytokines and chemokines within the IVD and that these expression patterns are altered in IVD pathology. These findings may be important for the correct assessment of the ‘degenerate niche’ prior to autologous or allogeneic cell transplantation for biological therapy of the degenerate IVD.

show abstract

“…Although some patients can be relieved by conservative treatment, persistent and severe pain often necessitates surgery. The first case of spontaneous resorption of the lumbar IVD in myelography was demonstrated in 1945 by Key et al ( 25 ). Since then, increasing reports have confirmed that LDH may spontaneously disappear with time without surgery ( 26 , 27 ), which should be considered by patients who choose not to have surgery.…”

Section: Discussionmentioning

confidence: 99%

“…MDSCs in turn inhibit the T cell cycle and immune checkpoints, down-regulate T cell receptors, and recruit regulatory T cells. They also suppress the activity of other immune cells through the production of ROS, RNS, degradation of L-arginine, and the production of anti-inflammatory factors, such as TGF-β and IL-10 ( 25 , 33 ). These factors further hinder the reabsorption process.…”

Section: Discussionmentioning

confidence: 99%

Increased levels of circulating granulocytic myeloid‑derived suppressor cells in lumbar disc herniation

Zhou

Liu

et al. 2023

Exp Ther Med

View full text Add to dashboard Cite

Myeloid-derived suppressor cells (MDSCs) expand when the body undergoes inflammatory diseases and chronic diseases. However, its role in intervertebral disc degeneration remains unclear. The present study aimed to characterize specific subsets of MDSCs as potential indicators of disease progression in patients with lumbar disc herniation (LDH). The Gene Expression Omnibus (GEO) database was used to analyze the changes in granulocyte MDSCs (G-MDSCs). Peripheral blood samples were collected from 40 patients with LDH and 15 healthy controls, and flow cytometry was used to characterize different subsets of MDSCs. All subjects underwent lumbar spine magnetic resonance imaging. Then, t-distributed stochastic neighborhood embedding and FlowSOM were used to analyze the data obtained by CytoFlex. The correlation between circulating MDSCs and the clinicopathological stage of LDH was then further analyzed. The GEO database predicted that G-MDSCs were highly expressed in patients with LDH. The frequency of circulating G-MDSCs increased with Pfirrmann stage III and IV, while the percentage of mononuclear MDSCs (M-MDSCs) only increased. Patient age and sex did not correlate with the frequency of circulating G-MDSCs and M-MDSCs. The results of the computer algorithm analysis were consistent with those of our manual gating. The present study showed that the occurrence of LDH led to changes in the MDSC subpopulation in the circulating peripheral blood of patients, and the frequency of circulating G-MDSCs in patients with clinical stage III and IV LDH increased with the degree of degeneration. The determination of G-MDSCs can be used as an auxiliary examination item for LDH.

show abstract

Intervertebral Disk Lesions Are the Most Common Cause of Low Back Pain With or Without Sciatica

Cited by 27 publications

References 0 publications

The inflammatory response in the regression of lumbar disc herniation

The inflammatory response in the regression of lumbar disc herniation

The cytokine and chemokine expression profile of nucleus pulposus cells: implications for degeneration and regeneration of the intervertebral disc

Increased levels of circulating granulocytic myeloid‑derived suppressor cells in lumbar disc herniation

Contact Info

Product

Resources

About