PREVALENCE AND SEVERITY OF SYSTEMIC CYTOKINE RESPONSE IN LUMBAR DISC HERNIATION (CHRONIC LOW BACK PAIN) PATIENTS

Lumbar Disc Herniation (LDH) is a mechanical and biochemical process, wherein disc comes in contact with spinal nerves causes compression, chemical irritation, inflammation and pain. Herniated disc tissue exhibits an inflammatory cellular infiltration and elevated pro-inflammatory cytokines. We compared cytokine levels in patients with chronic low back pain and in healthy subjects. Cytokine levels were measured using the enzyme-linked immunosorbent assay (ELISA) technique. Thirty five patients with low back pain (G1) and 17 healthy controls (G2) were selected. The pain duration among the herniated disc patients was 81 ± 99 months (median 34.5) and the pain intensity as measured using the numerical rating scale was 9.0 ± 1.7 (median 10). The location of the herniated intervertebral disc was at the L4-L5 levels in 60% of the patients and at the L5-S1 levels in 40%. Pain was continuous in 87% of the subjects, with a daily frequency in 87%. Chronic low back pain and disc herniation exhibited significantly higher levels of TNF-alpha and IL-6 compared with healthy controls. The conclusion is that serum proteins are considerable molecular markers of patients that develop constant pain after disc herniation