BIOCHEMICAL FEATURES OF RECURRENT HERNIAS OF THE LUMBAR INTERVERTEBRAL DISCS AT DIFFERENT STAGES OF THEIR DEGENERATION
https://doi.org/10.14531/ss2012.2.87-93
Abstract
Objective. To study biochemical changes in proteoglycans (PGs) of intervertebral disc tissues and stages of their degeneration in patients with recurrent disc herniation.
Material and Methods. A retrospective analysis of biochemical and radiological parameters of primary hernias of intervertebral discs from 16 patients who were reoperated on at the same level within three years was performed. Degenerated discs were classified according to the Pfirrmann’s criteria. The quantity of glycosaminoglycans (GAGs) in the hernia and surrounding annulus fibrosus tissues was determined by analytical biochemistry methods. The properties of PG in the hernia tissue were studied using composite gel electrophoresis.
Results. Two types of primary hernias were identified. The tissues of Type 1 hernias were characterized by high content of water, total GAG, and PG. But the number of GAGs lying in the deeper layers of tissue is extremely low. The tissues of Type 2 hernias showed reduced water content, GAG number, degree of their sulfation, and increased content of neutral hexoses. These hernias contain a large proportion of non-aggregated PGs and more than half of all GAGs are found in deeper layers of tissue. On MRI evidence Type 1 hernias corresponds to Grade III degeneration, and Type 2 - to Grade IV. Grade III degeneration predominates among the hernias, which recurrent within the first year after surgery.
Conclusion. The structure of tissue of primary disc hernias recurring after surgical removal demonstrates regular biochemical changes in PGs and GAGs, which are registered by MRI with different signal intensity. Hir. Pozvonoc. 2012;(2):87-93.
About the Authors
T. V. Rusova
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
E. S. Baikov
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
A. A. Baikalov
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
A. V. Krutko
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
S. S. Rabinovich
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
A. V. Novokshonov
Scientific Clinical Center of Miners’ Health Protection, Leninsk-Kuznetsky
Russian Federation
Russian Federation
References
1. Антипко А.Л. Прогнозирование рецидивов грыж межпозвонковых дисков поясничного отдела позвоночника на основе данных магнитно-резонансной томографии и математического моделирования: Дис. … канд. мед. наук. Воронеж, 2009.
2. Русова Т.В., Баитов В.С. Биохимические изменения протеогликанов суставного хряща при прогрессирующем остеоартрозе // Бюллетень СО РАМН. 2008. № 2(130). С. 25-29.
3. Adams MA, Roughley PJ. What is intervertebral disc degeneration and what causes it? Spine. 2006; 31: 2151-2161.
4. Dora C, Schmid MR, Elfering A, et al. Lumbar disk herniation: do MR imaging findings predict recurrence after surgical diskectomy? Radiology. 2005; 235: 562-567.
5. Gruber HE, Hanley EN. Recent advances in disc cell biology. Spine. 2003; 28: 186-193.
6. Johannessen W, Auerbach JD, Wheaton AJ, et al. Assessment of human disc degeneration and proteoglycan content using T1rho-weighted magnetic resonance imaging. Spine. 2006; 31: 1253-1257.
7. Kim KT, Park SW, Kim YB. Disc height and segmental motion as risk factors for recurrent lumbar disc herniations. Spine. 2009; 34: 2674-2678.
8. Kuh SU, Kwon YM, Chin DK, et al. Different expression of extracellular matrix genes: primary vs. recurrent disc herniations. J Korean Neurosurg Soc. 2010; 47: 26-29.
9. Laus M, Bertoni F, Bacchini P, et al. Recurrent lumbar disc herniation: what recurs? (A morphological study of recurrent disc herniation). Chir Organi Mov. 1993; 78: 147-154.
10. Marinelli NL, Haughton VM, Muñoz A, et al. T2 relaxation times of intervertebral disc tissue correlated with water content and proteoglycan content. Spine. 2009; 34: 520-524.
11. Martins DE, de Oliveira VM, de Seixas Alves MT, et al. Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs. Sao Paulo Med J. 2010; 128: 63-68.
12. Melrose J. Cartilage and smooth muscle cell proteoglycans detected by affinity blotting using biotinylated hyaluronan. Methods Mol Biol. 2001; 171: 53-66.
13. Melrose J, Smith SM, Little CB, et al. Recent advances in annular pathobiology provide insights into rim-lesion mediated intervertebral disc degeneration and potential new approaches to annular repair strategies. Eur Spine J. 2008; 17: 1131-1148.
14. Mwale F, Iatridis JC, Antoniou J. Quantitative MRI as a diagnostic tool of intervertebral disc matrix composition and integrity. Eur Spine J. 2008; 17(Suppl 4): 432-440.
15. Pfirrmann CW, Metzdorf A, Zanetti M, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001; 26: 1873-1878.
16. Risbud MV, Guttapalli A, Tsai TT, et al. Evidence for skeletal progenitor cells in the degenerate human intervertebral disc. Spine. 2007; 32: 2537-2544.
17. Taylor TK, Merlose J, Burkhardt D, et al. Spinal biomechanics and aging are major determinants of the proteoglycan metabolism of intervertebral disc cells. Spine. 2000; 25: 3014-3020.
Review
For citations:
Rusova T.V., Baikov E.S., Baikalov A.A., Krutko A.V., Rabinovich S.S., Novokshonov A.V. BIOCHEMICAL FEATURES OF RECURRENT HERNIAS OF THE LUMBAR INTERVERTEBRAL DISCS AT DIFFERENT STAGES OF THEIR DEGENERATION. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2012;(2):87-93. (In Russ.) https://doi.org/10.14531/ss2012.2.87-93
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