Correlation of tumor necrosis factor-α expression with pain level in degenerative lumbar canal stenosis patients

Yudha Mathan Sakti, Rahadyan Magetsari, David Yosua Parulian Hutahaean, Galih Prasetya Sakadewa, Paramita Dyah Lasmana, Nicolaas C. Budhiparama, Ery Kus Dwianingsih

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Pain in degenerative lumbar canal stenosis is caused by osteoarthritis of a facet joint and intervertebral disc degeneration. Some inflammatory mediators such as tumor necrosis factor (TNF)-α are present in degenerative lumbar canal stenosis. AIM: This study aimed to evaluate the correlation of pain and functional pre-operative scores with the expression of TNF-α in nucleus pulposus, annulus fibrosus, and facet joints. METHODS: Patients diagnosed with degenerative lumbar canal stenosis and planned for surgical treatment were included in this study. Patients with a history of fracture, neoplasm, and/or infection of the spine were excluded. Tissue samples were collected from the nucleus pulposus, annulus fibrosus, facet joint, flavum ligament, and paraspinal muscles of the spine during the surgery. TNF-α expression was examined semi-quantitively and correlated with the axial and radicular pain that was measured using the Visual Analog Scale (VAS) score. The result was then statistically analyzed. RESULTS: The expression of TNF-α in the paraspinal muscle was significantly higher compared to other locations. TNF-α expression in the facet joint group was significantly correlated with the intensity of low back pain measured by VAS score (r = 0.893, p < 0.001), and pre-operative functional outcome based on Oswestry Disability Index (ODI) (r = 0.948, p < 0.001). CONCLUSION: TNF-α expression, especially in the facet joint, is significantly associated with the pain intensity and pre-operative ODI that allow pain reduction with less invasive treatment in lumbar canal stenosis patients.

Original languageEnglish
Pages (from-to)1135-1139
Number of pages5
JournalOpen Access Macedonian Journal of Medical Sciences
Volume9
DOIs
Publication statusPublished - 26 Dec 2021
Externally publishedYes

Keywords

  • Degenerative lumbar canal stenosis
  • Low back pain
  • Tumor necrosis factor-α

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