title: Cerebrospinal fluid nitric oxide metabolites are novel predictors of pain relief in degenerative lumbar diseases.
abstract: This study was undertaken to determine whether or not nitric oxide metabolites (NO(2)(-) plus NO(3)(-): NOx levels) in cerebrospinal fluid (CSF) would be predictors of treatment outcome in patients with degenerative lumbar diseases (DLD) including lumbar disc herniation (LDH) and lumbar spinal canal stenosis (LCS). The NOx levels in CSF were measured using an NO analyzer based on the Griess method. Six healthy volunteers and 18 patients with painless diseases were included in the control group. The pre- and postoperative NOx levels in 25 DLD patients, who underwent herniotomy for LDH (17 patients) or selective decompression for LCS (eight patients), were analyzed. The postoperative follow-up periods were approximately 8 months. Nineteen of 25 DLD patients, whose preoperative NOx levels were two standard deviations higher than the mean NOx levels of an age-matched control group, were included in an NO elevated (NOE) group. Among the 25 DLD patients, the preoperative NOx levels in six patients (young LDH group) were within the normal range. The pain-related Japanese Orthopaedic Association score and the Hirabayashi recovery rate were respectively used to evaluate the pain severity and the degree of pain relief. The preoperative and changes of postoperative NOx levels in the NOE group were negatively correlated with the Hirabayashi recovery rate. Normal postoperative NOx levels and excellent pain relief were achieved in young DLD patients. In conclusion, the preoperative and changes in postoperative NOx levels are quantitative predictors of postoperative pain relief in DLD patients.
authors.affiliation: Department of Orthopedic Surgery, Niigata University School of Medicine, 1-757 Asahimachi-dori, Niigata-shi, 951-8510, Japan Department of Orthopedic Surgery, Kameda-Daiichi Hospital, Nishi-cho, Kameda-machi, Nakakanbara-gun, Niigata-ken 950-0165, Japan Department of Orthopedic Surgery, National Sanatorium Nishi-Niigata Chuou Hospital, 1-14-1 Masago, Niigata-shi, 950-2085, Japan Department of Neurophysiology, Brain Research Institute, Niigata University, 1-757 Asahimachi-dori, Niigata-shi, 951-8585, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kimura
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yajiri
authors.forename: Seiji
authors.initials: S
authors.lastname: Uchiyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Katsuei
authors.initials: K
authors.lastname: Shibuki
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000134:cerebrospinal fluid* / Q000601:surgery; D009569:Nitric Oxide / Q000134:cerebrospinal fluid*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000134:cerebrospinal fluid*; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide