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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 2, 196-201.
doi: 10.1302/0301-620X.84B2.12511  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators

J. G. Burke, FRCS I, Specialist Registrar in Orthopaedics1; R. W. G. Watson, PhD, Lecturer and Head of Laboratory1; D. McCormack, MCh, FRCS, Consultant Orthopaedic Surgeon1; F. E. Dowling, MCh, FRCS I, Consultant Orthopaedic Surgeon2; M. G. Walsh, MCh, FRCS I, Consultant Orthopaedic Surgeon1; and J. M. Fitzpatrick, MCh, FRCS I, Professor of Surgery1

1 Mater Misericordiae Hospital, 47 Eccles Street, Dublin 7, Ireland.
2 Meath/Adelaide/National Children’s Hospital, Tallaght, Dublin, Ireland.

Correspondence should be sent to Mr J. G. Burke at 55 Greenlee Drive, Little Benton, Newcastle Upon Tyne NE7 7GA, UK.

Herniated intervertebral disc tissue has been shown to produce a number of proinflammatory mediators and cytokines, but there have been no similar studies using discs from patients with discogenic low back pain.

We have compared the levels of production of interleukin-6 (IL-6), interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in disc tissue from patients undergoing discectomy for sciatica (63) with that from patients undergoing fusion for discogenic low back pain (20) using an enzyme-linked immunoabsorbent assay.

There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p < 0.006 and p < 0.003, respectively).

The high levels of proinflammatory mediator found in disc tissue from patients undergoing fusion suggest that production of proinflammatory mediators within the nucleus pulposus may be a major factor in the genesis of a painful lumbar disc.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General