Proinflammatory cytokines in the cerebrospinal fluid of patients with lumbar radiculopathy

Eur Spine J. 2011 Jun;20(6):942-6. doi: 10.1007/s00586-010-1595-3. Epub 2010 Oct 17.

Abstract

In pathologic radicular pain of lumbar spinal stenosis, cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins (ILs) play a crucial role in the pathogenesis of nerve degeneration and pain. We investigated TNF-α and IL-6 levels in the cerebrospinal fluid (CSF) of patients with radicular pain caused by lumbar spinal stenosis (LSS). A total of 30 LSS patients and 10 age-matched controls were examined. CSF samples were obtained adjacent to the level of stenosis in 30 LSS patients, and at the L4-L5 level in the 10 control patients. TNF-α and IL-6 levels in the samples were analyzed using enzyme-linked immunosorbent assays (ELISA). We compared the amounts of TNF-α and IL-6 with severity of pain (low back and leg pain), walking ability, and severity of stenosis (cross-sectional area of dural space). The concentration of IL-6 was significantly higher in LSS patients than in controls, but TNF-α levels were beneath the limit of detection. There was no correlation between IL-6 levels and severity of pain or walking ability (p > 0.05). However, there was a significant correlation between IL-6 levels and severity of stenosis (p < 0.05). The current study showed that the increased CSF IL-6 levels in LSS patients with radicular pain were not correlated with pain severity; although not proven in this study, the increase in CSF IL-6 concentration could indicate pathological nerve damage or degeneration of lumbar radiculopathy represented by the severity of stenosis.

MeSH terms

  • Aged
  • Humans
  • Interleukin-6 / cerebrospinal fluid*
  • Low Back Pain / cerebrospinal fluid*
  • Low Back Pain / etiology
  • Lumbar Vertebrae
  • Middle Aged
  • Pain Measurement
  • Radiculopathy / cerebrospinal fluid*
  • Radiculopathy / etiology
  • Severity of Illness Index
  • Spinal Stenosis / cerebrospinal fluid*
  • Spinal Stenosis / complications
  • Tumor Necrosis Factor-alpha / cerebrospinal fluid*

Substances

  • Interleukin-6
  • Tumor Necrosis Factor-alpha