Study On The Correlation Between MRI Endplate Inflammation Classification And Disc Degeneration Classification And The Mechanism Of Netrin-1 In The Treatment Of This Disease

Objective1 In order to explore the relationship between MRI inflammation endplate classification and the grading index of intervertebral disc degeneration,providing evidence for clinical diagnosis and treatment of related diseases.2 In order to study the expression of DRG Netrin-1 corresponding to the degenerative intervertebral disc nerve,and the effect of electroacupuncture at Jiaji points on it.Provide theoretical basis for clinical treatment of this disease.Method1 A total of 80 patients with main complaints of waist or lower limb pain and discomfort between June and December 2020 were selected for MR examination.After screening according to the diagnostic criteria,inclusion criteria and exclusion criteria,62cases were finally confirmed.After each patient obtained the sagittal T1WI and T2WI sequence,the endplate inflammation type was determined according to the Modic classification method,and the Pfirrmann standard was used to evaluate the grade of lumbar disc degeneration of each patient.Pearson correlation analysis was used to analyze the correlation between the endplateitis classification and the grade of lumbar intervertebral disc degeneration.P（27）0.05is statistically significant.If there is a significant correlation,regression analysis is performed to calculate the r²value.2 Select 20 adult male New Zealand white rabbits and divide them into 5 groups:normal group,model group,sham model group,electroacupuncture group,acupuncture group,4 rabbits in each group,no treatment for normal group,the model group of rabbits were built rabbit models by using classic Kirschner wires and a pressurizer to act on the L₄and L₅vertebral bodies.The sham model group was treated the same as the model group but without pressure.Electroacupuncture group was treated electroacupuncture on corresponding Jiaji points based on the"Experimental Acup-moxibustion Science"point location method of experimental animals,the treatment course is 4 weeks;the treatment of the acupuncture group is the same as that of the electric acupuncture group but without electricity.After the experiment,all animals were sacrificed and the corresponding DRG（L₂）was taken out,and the specimens were processed by Western blot and immunohistochemistry.One-way analysis of variance（one-way ANOVA）was used to test whether the expression of DRG Netrin-1 in different groups was different,and then a post-hoc analysis（Tukey’s post hoc test）was performed.P（27）0.05 was statistically significant.Result1 There is a positive correlation between the MRI endplate inflammation classification and the Pfirrmann classification of intervertebral disc degeneration,the correlation coefficient r=0.527（P（27）0.01）;in the regression analysis,the adjusted r²=0.266（P（27）0.01）.2 Successfully established a model of intervertebral disc degeneration.Western blot found that Netrin-1 was abundantly expressed in DRG in the L₂segment of the normal group and the sham model group;in the model group,the expression of Netrin-1 and m RNA in the DRG of the corresponding segment of the degenerated intervertebral disc decreased.After 28 days of electroacupuncture,Netrin-1 And m RNA expression levels were up-regulated;in the acupuncture group,Netrin-1 and m RNA expression levels were not significantly up-regulated.Immunohistochemistry found that in the DRG of the normal group and the sham model group,the expression level of Netrin-1 was abundant,and the average proportion of Netrin-1 positive cells was 38.8%and 40.7%,respectively.In the model group,the expression of DRG Netrin-1 was down-regulated,and the expression of Netrin-1 in the electroacupuncture group was up-regulated,while in the acupuncture group,Netrin-1 was not overturned.Conclusion1 MRI endplate inflammation classification is positively correlated with the Pfirrmann grading index of intervertebral disc degeneration,and inflammation endplate is a risk factor for intervertebral disc degeneration.2 The down-regulation of Netrin-1 expression in DRG may be the cause of the inward growth of sensory nerves in the degenerated intervertebral disc.Electroacupuncture treatment of the corresponding Jiaji points can reverse this phenomenon and delay the degeneration of the intervertebral disc.