| Objectives: To analyze correlations between three factors remarkably correlative to lumbar disc herniation(LDH), i.e. contents of TNF-αand NO in human herniated lumbar discs, symptom scores of the patients with lumbar disc herniation and ratios of the maximal sagittal diameters of hernias to spinal canals at the same level on CT scans. To provide the theoretical evidences for prevention and treatment of lumbar disc herniation. The scoring form of clinical symptoms and signs of the patients with lumbar disc herniation (i.e. the scoring form of low back pain) used in the present study was based on the Dallas Pain Questionnaire (DPQ), JOA score and pain-scoring method (the density of low back pain was classified into five grades) developed by Hou shuxun and Wu wenwen. Therefore, the objective and quantitative parameters were obtained. Because there existed differences in development of the spinal canals of the patients with lumbar disc herniation, the S-index suggested by Thelandler and by Lian Zhi, which describes the size of hernia by ratio of the maximal sagittal diameter of hernia to spinal canal atthe same level, was used in the present study. The data obtained by the method were accurate and suitable for comparison each another. Methods: The 30 patients who underwent surgery for primary lumbar disc herniation were investigated. Among the 30 patients were 18 men and 12 women. The average age was 42.9 years(rang, 25-70 years). The average duration of symptom before surgery was 28.8 months (range, 15days-12 years). The hernias were classified into four types: 2 with protrusion, 20 with herniation(including 16 lateral and 4 central herniations), 6 with extrusion (including 3 subligamentous and 3 transligamentous extrusions) and 2 with sequestrution. The diaganostic criteria and pathological type for lumbar disc herniation were based on Lumbar Intervertebral Disc Herniation written by Lu Yulai and Cai Qinlin(published by the People Military Hospital Publishing House, the first edition, May in 2001). The 30 patients were asked to prescribe their medical histories. Besides the normal examinations, the lumbar vertebra radiography and CT were performed to exclude the influential factors such as rachiterate, spondylolisthesis, infection, tumor, tuberculosis and immune diseases before surgery. The part of the patients accepted myelography and /or MRI. Every patient was examined physically by two orthopedic surgeons respectively in the different time before surgery. Two protocols of every patient were scored by the scoring form of low back pain andthe mean of two scores was calculated. All the patients were underwent the fenestration and discectomy. Seventeen specimens were from the L4-L5 level and thirteen from the L5-S1 level. The 5 patients who underwent decompression for lumbar burst fracture were served as the control group. Three specimens was from the T12-L1 level and two from the L1-L2 level by surgery. They proved to have no history of lumbar disc herniation. The 35 specimens were washed three times with normal saline solution to remove all blood and kept in a freezer at –70℃ until examination. After the specimens had been finished collecting, a set of programs were carried out of homogenation, centrifugation and the supernatants of the specimens were obtained for measuring contents of TNF-αand NO by ELISA and Giess respectively. The quasi-experiment was carried out before primary experiment. Finally, all the data obtained in the present study were analyzed statistically by SPSS10.0 computer program. Results: Contents of TNF-αand NO in herniated lumbar discs were 6.05±0.33ng/ml/g and 4.33±0.29μmol/gprot, and contents of TNF-αand NO in lumbar discs of the control group were 2.17±0.24ng/ml/g and 0.72±0.11μmol/gprot respectively. There was significant difference in contents of TNF-αand NO in lumbar discs of the experiment and control group by the Student's t test(P<0.01). The results from linear correlation showed as follows: contents of TNF-αand NO in herniated lumbar...
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