Study On Mutual Relationship Of MRI-T₂ Signal Value, Expression Of Interleukin 1,6 Of Intervertebral Disc And JOA In Patients With Discogenic Low Back Pain

Object To valuate the MRI-T2 signal value and JOA score, to test the expression of interleukin1, 6 in intervertebral disc of patients with discogenic low back pain(DLBP) and to explore the mutual relationship respectively. Method(1) 20 people suffered DLBP diagnosed by three spine surgeons independently with age ranged from 45 to 65 years came from the same race and area. The inclusion criteria were: ① with a repeated low back pain lasted more than 3 months. ② for 2 months after taking NSAIDS without alleviation of pain. ③ there was obvious lumbar disc degeneration without clear mechanical compression of the nerve root by MRI. ④ The same pain was copied or stimulated by discography. ⑤ the degenerated lumbar segment was associated with segmental instability. The exclusion criteria were: ① with diabetes, hypertension or(and) other microvascular disease. ② with immunodeficiency and acute or chronic infection. ③ long-term smoker(2) All patients received lumbar MRI examination before operation with 3.0 T Philips MRI machine(The TR=3500ms, TE were 90/120ms). The relative value of T2 was obtained by the T2 value of nucleus pulposus in middle sagittal plane divided by the T2 value of back fat with software IViewbold. The every relative value of T2 was valuated 3 times repeatedly and got average value.(3) The clinical index of low back pain was evaluated by modified Japanese Orthopedic Association scores(Japanese Orthopedic Association scores, JOA score), the highest score was 29, the lowest score was 0, the lower the score was, the severer the dysfunction of the patients was.(4) All the patients were treated by posterior lumbar discectomy, fusion and pedicle screw fixation. The specimens of nucleus pulposus and fibrous annulus got from the involved intervertebral disc with a homemade tool with an average size of 1cm, then fixed and cryopreservated.(5) The expression levels of IL-1 and IL-6 in the intervertebral disc tissue was tested by coomassie brillant blue G-250 method.(6) The correlation of T2 ratio, IL-1,IL-6 and JOA score were analyzed by SPSS19.0 statistical analysis software respectively and the Hypothesis testing standards were r>0.75, p<0.75. Results(1) The linear correlation analysis results of T2 ratio value and IL-1 revealed that with r=-0.787, P<0.05, the correlation of T2 ratio value and the expression of IL-1 level was negatively related.(2) The T2 ratio value and the expression of IL-6 was linear correlation with negative relationship with r=-0.872, P <0.05.(3) The T2 ratio value and JOA score was linear correlation with positive relationship with r=-0.890, P <0.05. Conclusion( 1). The T2 ratio value was negatively correlated with the expression of IL-1 and IL-6 and IL-1 and IL-6 may played an important role in nucleus pulposus degeneration.(2). The T2 ratio was positively correlated with the JOA score, may means that the T2 ratio is valuable for diagnosing for DLBP.