A Contrastive Study Of TNF-α And IL- 1 Expresssion In Lumbar Intervertebral Disc Between Lumbar Disc Herniationand Lumbar Spinal Stenosis

BackgroundLumbar disc herniation(LDH) and Lumbar spinal stenosis disease(LSS) are the two main lumbar intervertebral disc degenerative diseases, their incidence has a rising trend year by year). Studies have proved that Lumbar disc degeneration(LDD) is the pathophysiologic basis of Lumbar disc herniation. There are many factors affect the process of LDD, and the inflammatory response plays a very important role among them. But the mechanism of different inflammatory factors is not clear. Patients with LSS tends to be older and have a relatively long duration, and the accompanying disc ptotrution is slight, whether the pathophysiologic performance of these patients is more likely to be a lumbar disc aging process is also not clear. ObjectiveTo discuss the role lumbar disc degeneration and lumbar disc aging play in LDH and LSS by observing TNF-α and IL-1 expresssion in lumbar intervertebral disc between lumbar disc herniation and lumbar spinal stenosis. MethodsFrom August 2012 to January 2015,67 cases of lumbar disc herniation tissue and 31 cases of lumbar spinal stenosis tissue which is clinical diagnosed and Surgery confirmed are selected.The lumbar disc herniation tissue cases were classified into two groups by the operational findings:herniation type(the intervertebral disc tissue is broken and soft,and difficult to cut off a large piece of intervertebral disc tissue),40cases; protrution type(the intervertebral disc tissue is complete and qualitative hard, and easy to cut off a large piece of intervertebral disc tissue),27cases; Lumbar spinal stenosis is another group,31 cases.To observe the histomorphology changes by HE staining method, and to observe the TNF-α,IL-6 expression in cells by immunohistochemical staining method. Results40 cases of herniation type:patients aging from 17 to 65 years old,with a mean age of 41.2 years old.The intervertebral disc collagen fiber is fractured and thin. Histopathological examinations mainly showed Obvious vascularization、destruction and inflammation,with a high expression of TNF-α,IL-6 positive cells.27 cases of protrution type:patients aging from 32 to 72 years old,with a mean age of 56.5 years old. The intervertebral disc collagen fiber is thicken. Histopathological examinations mainly showed hyperplasia of disorder,no or less serious vascularization and inflammation. Less TNF-α,IL-6 positive cells can be observed.31 cases of Lumbar spinal stenosis Group:patients aging from 44 to 69 years old,with a mean age of 58.6 years old.The Histopathological performance is similar to the protrution type,mainly showed hyperplasia of disorder,no or less vascularization,and inflammation can be observed. Conclusion1.TNF-α and IL-1 positive cell has a high expression in lumbar disc herniation, and the histopathological performance of the this type mainly showed obvious vascularization 、destruction and inflammation2.TNF-α and IL-1 positive cell has a low expression in protrusion type and LSS, and the histopathological performance of the this type mainly showed hyperplasia of disorder and less no or less vascularization...