Architectonic Study Of Discogenic Low Back Pain's Intercalated Disc And Clinical Significance Of Monitoring Serum 6-keto-PGE1α Level

Objective: To observe the architectonic change of intercalated disc in patients with discogentic low back pain, monitor serum 6-keto-PGE1αlevel and recode clinical PI-NRS (pain intensity numerical rating scale) pain scores, study the dependability between serum 6-keto-PGE1αlevel and significance of discogentic low back pain's permeability change,and explore the nosogenesis of discogentic low back pain and the reliability of serum 6-keto-PGE1αas a inflammation maker in discogentic low back pain.Methods:①20 patients were randomly selected .The investigation of the lumbar vertebrae was made by means of the X-ray and MRI .The histological examinations of the end-plate cartilage,annular fibrosus and nucleus pulposus were performed. These patients were divided into 2 groups: pre- treatment group and post-treament group. Serum 6-keto-PGE1αconcentration was measured before therapy and after therapy respectively. According to PI-NRS pain scores, pre- treatment group were divided into 3 groups :group A1 n=6, PI-NRS 0~3; group A2 n=10, PI-NRS 3~6, group A3 n=4, PI-NRS 7~10.②10 volunteer peoples who were health blood donor were involved in the study as the control group, and also measured serum 6-keto-PGE1α.③The final data were analyzed with the SPSS 13.0.Results:①Low signal intensity were found in every affection by MRI, End-plate were found thinner and disaggregative in 4 cases,intercalated disc absorption and intervertebral space stenosis were found in 2 cases; End-plate cartilage,annular fibrosus and nucleus pulposus were found degenerative in all cases by light microscope, but no differences in the X-ray.②The serum 6-keto-PGE1αlevel in pre- treatment group,post-treament group and control group were 53.8470±13.763 pg/mL, 46.1025±5.516 pg/mL, 44.1390±6.809 pg/mL respectively. The concentration of serum 6-keto-PGE1αin pre- treatment group was higher than those in post-treament and control group ,the difference was significant (P<0.05).The serum 6-keto-PGE1αlevel in post-treament group was lower than that in control group. The difference is insignificant (P>0.05).③The serum 6-keto-PGE1αlevel in Group A1,Group A2 and Group A3 were 41.8367±8.973 pg/mL, 54.3650±7.423 pg/mL,and 69.5675±10.509 pg/mL , the difference was significant (P<0.05).These showed that the ascending of PI-NRS pain scores was related to the elevator of the levels of Serum 6-keto-PGE1αin discogentic low back pain.Conclusion :①The degeneration of intercalated disc is the patho-foundation of discogentic low back pain.②6-keto-PGE1αhas correlation with discogentic low back pain,monitoring serum 6-keto-PGE1αlevel can well reflect the discogentic low back pain's permeability changes and inflammation level in intercalated disc.③The results indicate that there was a correlation among the degrees of inflammations, the levels of 6-keto-PGE1αin discogentic low back pain and clinical PI-NRS pain scores. According clinical PI-NRS pain scores ,we can judge the degrees of inflammations of the involved nerve roots and surrounding tissues.