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Indomethacin blocks the nucleus pulposus-induced effects on nerve root function

An experimental study in dogs with assessment of nerve conduction and blood flow following experimental disc herniation

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Abstract

Inflammatory mechanisms have been suggested to be involved in the basic pathophysiologic events leading to nerve root injury after local application of nucleus pulposus. To assess if these nucleus pulposus-induced effects could be blocked by anti-inflammatory treatment, 41 dogs were exposed to either incision of the L6-7 disc to induce experimental disc herniation with (n=12) or without (n=14) indomethacin treatment per os (5 mg/kg per day), and no incision with (n=5) or without (n=10) indomethacin. Intraneural blood flow and nerve conduction velocity were assessed after 7 days to evaluate the degree of nerve injury. Disc incision induced a reduction in nerve root and dorsal ganglion blood flow as well as nerve function, similarly to previous studies. However, simultaneous treatment with indomethacin efficiently blocked the negative effects on both blood flow and nerve conduction but had no effects per se. The present study thus indicates that inflammatory mechanisms may be of relevance in the pathophysiology of nucleus pulposus-induced nerve root injury and thereby also for sciatica.

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References

  1. Byröd G, Olmarker K, Konno S, Larsson K, Takahashi K, Rydevik B (1995) A rapid transport route between the epidural space and the intraneural capillaries of the nerve roots. Spine 20: 138–143

    Article  PubMed  Google Scholar 

  2. Byröd G, Olmarker K, Nordborg C, Rydevik B (1998) Early effects of nucleus pulposus application on spinal nerve root morphology and function. Eur Spine J 7: 445–449

    Article  PubMed  Google Scholar 

  3. Grönblad M, Virri J, Tolonen J et al (1994) A controlled immunohisto-chemical study of inflammatory cells in disc herniation tissue. Spine 19: 2744–2751

    Article  PubMed  Google Scholar 

  4. Grönblad M, Virri J, Rankko S et al (1996) A controlled biochemical and immunohistochemical study of human synovial type (group II) phospholipase A2 and inflammatory cells in macro-scopically normal, degenerated and herniated lumbar disc tissues. Spine 21: 2531–2538

    Article  PubMed  Google Scholar 

  5. Kayama S, Konno S, Olmarker K, Yabuki S, Kikuchi S (1996) Incision of the annulus fibrosus induces nerve root morphologic, vascular and functional changes. Spine 21: 2539–2543

    Article  PubMed  CAS  Google Scholar 

  6. Kayama S, Olmarker K, Larsson K, Sjögren-Jansson E, Lindahl A, Rydevi B (1998) Cultured, autologous nucleus pulposus cells induce functional changes in spinal nerve roots. Spine 23: 20: 2155–2158

    Article  PubMed  CAS  Google Scholar 

  7. Korbine AI, Doyle TF, Martins AN (1974) Spinal cord blood flow in the rhesus monkey by the hydrogen clearance method. Surg Neurol 2: 192–200

    Google Scholar 

  8. McCarron RF, Wimpee MW, Hudkins P, Laros GS (1987) The inflammatory effect of nucleus pulposus. A possible element in the pathogenesis of low-back pain. Spine 12: 760–764

    Article  PubMed  CAS  Google Scholar 

  9. Myers RR, Murakami H, Powell HC (1986) Reduced nerve blood flow in edematous neuropathies: a biomechanical mechanism. Microvasc Res 32: 145–151

    Article  PubMed  CAS  Google Scholar 

  10. Olmarker K, Rydevik B, Nordborg C (1993) Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots. Spine 18: 1425–1432

    Article  PubMed  CAS  Google Scholar 

  11. Olmarker K, Byröd G, Cornefjord M, Nordborg C, Rydevik B (1994) Effects of methyl-prednisolone on nucleus pulposus-induced nerve root injury. Spine 19: 1803–1808

    Article  PubMed  CAS  Google Scholar 

  12. Olmarker K, Blomquist J, Strömberg J, Nannmark U, P Thomsen, Rydevik B (1995) Inflammatogenic properties of nucleus pulposus. Spine 20: 665–669

    Article  PubMed  CAS  Google Scholar 

  13. Olmarker K, Rydevik B, Nordborg C (1996) Ultrastructural changes in spinal nerve roots induced by autologous nucleus pulposus. Spine 21: 411–414

    Article  PubMed  CAS  Google Scholar 

  14. Otani K, Kikuchi S, Arai I, Mao GP, Konno S, Olmarker K (1997) Experimental disc herniation. Evaluation of the natural course using assessment of changes in nerve conduction of the spinal nerve roots and MRI changes of the intervertebral discs. Spine 22: 2894–2899

    Article  PubMed  CAS  Google Scholar 

  15. Otani K, Arai I, Mao GP, Konno S, Olmarker K, Kikuchi S: Nucleus pulposus-induced nerve root injury. The relationship between blood flow and nerve conduction velocity. Neurosurgery 45:614–619

  16. Otani K, Mao GP, Arai I, Konno S, Olmarker K, Kikuchi S. Nucleus pulposus-induced increase in vascular permeability in the nerve root. (Unpublished)

  17. Rydevik B, Myers RR, Powell HC (1989) Pressure increase in the dorsal root ganglion following mechanical compression. Closed compartment in the nerve root. Spine 14: 574–576

    Article  PubMed  CAS  Google Scholar 

  18. Saal JS, Franson RC, Dobrow R, Saal JA, White AH, Goldthwaite N (1990) High levels of inflammatory phospholipase A2 activity in lumbar disc herniations. Spine 15: 674–678

    Article  PubMed  CAS  Google Scholar 

  19. Stossec K, Luebbers DW, Cottin N (1974) Determination of local blood flow (micro-flow) by electrochemically generated hydrogen. Construction and application of the measuring probe. Pflugers Arch 348: 225–238

    Article  Google Scholar 

  20. Takino T, Takahashi K, Miyazaki T, Matsui T, Tomita K (1997) An immunohistochemical study of inflammatory cell appearance in rabbits nucleus pulposus. Neuroorthop 20: 113–120

    Google Scholar 

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Correspondence to Itaru Arai.

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This study was supported by grants from the Fukushima Medical Research Promotion Foundation and the Swedish Medical Research Council (9758)

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Arai, I., Mao, G.P., Otani, K. et al. Indomethacin blocks the nucleus pulposus-induced effects on nerve root function. Eur Spine J 13, 691–694 (2004). https://doi.org/10.1007/s005860100268

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  • DOI: https://doi.org/10.1007/s005860100268

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