Correlation between inflammatory cytokines released from the lumbar facet joint tissue and symptoms in degenerative lumbar spinal disorders

doi:10.1007/s00776-006-1105-y

Journal of Orthopaedic Science

Volume 12, Issue 2, March 2007, Pages 154-160

https://doi.org/10.1007/s00776-006-1105-y Get rights and content

Abstract

Background

Lumbar facet joint tissue has inflammatory cytokines. However, no reports have shown whether inflammatory cytokines in the facet joint leads to pain. This study was designed to characterize the correlation between inflammatory cytokines released from facet joint tissue and symptoms in degenerative lumbar spinal disorders. The purpose of this study was to seek involvement of inflammatory facet joint for radiculopathy in lumbar spinal canal stenosis with clinical and anatomical studies.

Methods

Lumbar facet joint cartilage and synovial tissues in 40 cases of posterior lumbar surgery were harvested to measure tumor necrotizing factor-α (TNFα), interleukin-1β (IL-1β), and interleukin-6 (IL-6) during operation. The visual analogue scale (VAS) and Roland-Morris disability questionnaire (RDQ) were used to examine the correlation between cytokine concentration and symptoms. Coloring agent was injected into facet joints of fresh cadavers to find leakage of pigment from the facet joint into the spinal canal.

Results

Inflammatory cytokines were detected in the joint tissues in the lumbar spinal canal stenosis (LSCS) and lumbar disc herniation (LDH) groups. A positive reaction rate of IL-1β was signifi cantly higher in the LSCS group than in the LDH group. IL-1β-positive cases in the LSCS group showed higher VAS scores for leg pain and higher RDQ scores. Intraspinal canal tissues including lumbar nerve root were stained by injection of methylene blue into the facet joints.

Conclusions

IL-1β in facet joint cartilage in LSCS was associated with leg pain and a decline of quality of life. Inflammatory cytokines produced in degenerated facet joint may leak into the intraspinal space through the lateral part of the ventral facet joint capsule. These results suggest the involvement of inflammatory cytokines in degenerated lumbar facet joints regarding the genesis of pain production.

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In addition, electric fields induced by PRF have anti-inflammatory effects. Previous studies by Igarashi et al.21 and Sluijter et al.18 demonstrated that PRF stimulation reduced the levels of inflammatory cytokines, such as interleukin-1β, tumor necrosis factor-α, and interleukin-6. Several studies reported that intra-articular PRF reduced serum C-reactive protein and cytokine levels.18,22,23
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Generally, lumbar DS is an anatomic finding that develops as a result of inflammatory and remodeling FJ processes. Except for prostaglandins (e.g., prostaglandin E2 [PGE2]), inflammatory cytokines, such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α), play a major role in the mediation of osteoarthritic changes in animals and humans [8–10]. These cytokines and matrix-degrading enzymes disturb chondrocyte metabolism, leading to cartilage degradation.
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Original articleCorrelation between inflammatory cytokines released from the lumbar facet joint tissue and symptoms in degenerative lumbar spinal disorders

Abstract

Background

Methods

Results

Conclusions

Original article
Correlation between inflammatory cytokines released from the lumbar facet joint tissue and symptoms in degenerative lumbar spinal disorders