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PhD Seminar – The association between proinflammatory cytokines, microbial infection, imaging and clinical manifestation in sciatica patients

August 13 @ 09:00 - 11:00 IDT

Background and aims: Sciatica associated with lumbar disc herniation is presumably caused by either nerve root compression or inflammation. However, patterns of sensory signs and symptoms vary between patients and are poorly correlated with MRI characteristics of the herniated disc and with evidence of local inflammation. The present study was aimed to search for associations between quantitative sensory testing (QST) patterns, MRI findings and disc cytokine levels in patients with sciatica.

Methods: This is an ongoing study. Patients scheduled for lumbar discectomy for sciatica undergo QST assessment according to a modified DFNS protocol. During surgery, intervertebral disc material is harvested for inflammatory mediators (interleukin (IL)-1b, IL-6, IL-8, IL-17, interferon-gamma and TNF-a) analysis using real-time polymerase chain reaction. MRI scans are assessed for disc protrusion volume and direction. K-means cluster analysis is being used to determine subjects subgrouping, which will be correlated with the MRI and inflammatory parameters.

Results: Thus far, 40 patients were studied. Based on 7 QST variables, two subgroups of patients were identified:
subgroup-1 (n=18) exhibiting high mean Z-scores (mechanical and thermal hypersensitivity), differing from
subgroup-2 (n=22), exhibiting low mean Z-cores (loss of sensory function). Further results are pending.

Conclusions: Preliminary results indicate that patients with sciatica can be classified into at least two (of the 3 DFNS) QST subgroups. By completing this study we hope to be able to correlate each subgroup with a specific inflammatory and disc morphology pattern, and by that to reveal the mechanism (inflammation versus compression) underlying each sensory profile.


August 13
09:00 - 11:00
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