Histomorphology and immunohistochemical patterns in degenerative disc disease and clinical-radiological correlations: a prospective study

European spine journal

article

Massimo Miscusi¹  Cristina Carnevali²  Luca Ricciardi³  Selenia Miglietta⁴  Vincenzo Petrozza⁵  Jessica Cacciotti⁵  Antonella Calogero⁶  Paolo Rosa⁶  Giuseppe Familiari⁷  Antonino Raco¹ 

[1] Azienda Ospedaliera Sant’Andrea;Università degli studi di Perugia;UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico;Dipartimento di Anatomia;UOC di Anatomia Patologica, ICOT;Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche;Dipartimento di Scienze Anatomiche

关键词: Disc;    Spine;    Degenerative disc disease;    Infammatory pathways;    Target medicine;    Conservative management;   

DOI  :  10.1007/s00586-020-06412-9

来源: Springer

【 摘 要 】

Degenerative disc disease (DDD) is a common condition causing low-back pain, disability and, eventually, neurological symptoms. This investigation aimed to investigate intervertebral disc DDD-related changes, evaluating histomorphology and cytokines secretion, and their clinical-radiological correlations. This is a monocentric prospective observational study. A cohort of patients who underwent microdiscectomy for DDD, from June 2018 to January 2019, were enrolled. Discs samples were examined for histomorphology, chondrons count, immunohistochemistry for Hif-1α, Nf200 and Egr-1. Demographical and clinical data were also collected. Twenty patients were finally included. MRI evaluation showed a Modic I alteration in nine patients and a Modic II in 11. The disability grade was low-moderate (ODI score was ≤ 40%) in eight patients and high (ODI score > 40%) in 12. The Modic I was associated with a low-moderate disability in two (22%) patients and to a high disability in seven (88%) (p  40% groups, there were a significative higher mean disability grade 48.4 (± 8.3)%, number of chondrons per section, cells per chondron, Nf200+ nerve fibers and Hif-1α expression, compared with Modic II and ODI ≤ 40% groups, respectively. There were no differences in terms of Egr-1 expression. The discs with Modic I MRI signal could represent potential targets for medical treatments, whereas Modic II seems to be a more likely point of no return in a degenerative process. Therefore, further investigations are to better investigate inflammatory pathways and degenerative mechanisms in DDD.

【 授权许可】

Unknown