Expression And Clinical Significance Of COX-2 And VEGF In Lumbar Disc Herniation

Objective:To investigate the expression of cyclooxygenase-2(COX-2) and vascular endothelial growth factor(VEGF) in lumbar disc herniation and explore their significance in the pathogenesis of intervertebral disc degeneration and lumbar disc hernaiton. Furthermore, to study the association between the expression of COX-2 and sciatica.Methods: 62 discs from patients with lumbar disc herination(22 protrusion type,20 extrusion type,20 sequestration type) were collected. The specimens were obtained from two zone of disc: A zone was hernia tissue or separate fragment , B zone was the remainder nucleus pulpous of lumbar intervertebral disc. Patients'sciatica pain were evaluated by a visual analog scale preoperatively. In control group, 12 normal discs were harvested from 4 young fresh autopsy . The specimens were obtained from two zone of disc: A zone was the margin of lumbar intervertebral disc , B zone was the center nucleus pulpous of lumbar intervertebral disc. The expression of COX-2 and VEGF were evaluated immunohistochemically, and their average optical by image analysis system were assay.Results: COX-2 and VEGF were overexpressed in LDH group compare with those in control group(P<0.01). Three different types of herniation have different expressions of COX-2 and VEGF statistically(P<0.01). The expression of COX-2 and VEGF were higher in extrusion and sequestration type as compared with protrusion type(P<0.01). The expression of COX-2 and VEGF were different in two zone of LDH group(P<0.01). A positive correlation was found between the expression of COX-2 and VEGF in LDH group(r=0.855, P<0.01). Three different types of LDH have different VAS score of sciatica statistically(P<0.01).The VAS pain score of sciatica were positive correlated with the expression of COX-2 in LDH group((r=0.807, P<0.01).Conclusion: COX-2 and VEGF were involved in the pathogenesis of lumbar disc degeneration and lumbar disc hernaiton. COX-2 and VEGF play critical role in the development of lumbar disc degeneration and herniation. COX-2 might play a key role in the expression of VEGF in LDH. Clinician can use VAS pain score to assess the severity of inflammation in sciatica patients.