STUDY DESIGN: A prospective series of biochemical assays for prostaglandin E2 content in symptomatic herniated lumbar disc specimens. OBJECTIVES: To help clarify the pathogenesis of lumbar radiculopathy. SUMMARY OF BACKGROUND DATA: Three recent studies have shown elevated levels of prostaglandin E2 in intervertebral disc herniations. None of these studies correlated symptoms with prostaglandin E2 levels. METHODS: Twenty-four disrupted disc samples were purified by a standard solid phase extraction method and analyzed for prostaglandin E2 with an enzyme-linked immunosorbent assay. Clinical and anatomic correlations were sought with analysis of variance and t test. RESULTS: Sequestered discs tended to be associated with a higher prostaglandin E2 content than extruded discs, which in turn, tended to be associated with higher prostaglandin E2 content than protruded ones. A positive straight leg raising test appeared to be associated with a higher prostaglandin E2 content than a negative test. CONCLUSIONS: Prostaglandin E2 appears to mediate some of the inflammatory effects of lumbar disc herniation. An intact anulus may provide some protection against this stimulus.
STUDY DESIGN: A prospective series of biochemical assays for prostaglandin E2 content in symptomatic herniated lumbar disc specimens. OBJECTIVES: To help clarify the pathogenesis of lumbar radiculopathy. SUMMARY OF BACKGROUND DATA: Three recent studies have shown elevated levels of prostaglandin E2 in intervertebral disc herniations. None of these studies correlated symptoms with prostaglandin E2 levels. METHODS: Twenty-four disrupted disc samples were purified by a standard solid phase extraction method and analyzed for prostaglandin E2 with an enzyme-linked immunosorbent assay. Clinical and anatomic correlations were sought with analysis of variance and t test. RESULTS: Sequestered discs tended to be associated with a higher prostaglandin E2 content than extruded discs, which in turn, tended to be associated with higher prostaglandin E2 content than protruded ones. A positive straight leg raising test appeared to be associated with a higher prostaglandin E2 content than a negative test. CONCLUSIONS:Prostaglandin E2 appears to mediate some of the inflammatory effects of lumbar disc herniation. An intact anulus may provide some protection against this stimulus.
Authors: Mohammed F Shamji; Lori A Setton; Wingrove Jarvis; Stephen So; Jun Chen; Liufang Jing; Robert Bullock; Robert E Isaacs; Christopher Brown; William J Richardson Journal: Arthritis Rheum Date: 2010-07