Herniation of cervical intervertebral disc: immunohistochemical examination and measurement of nitric oxide production.
METHODS
Surgically obtained cervical herniated intervertebral discs were examined histologically and immunohistochemically. The production of nitric oxide (NO) in the local tissue was examined using the electron spin resonance (ESR) method.


OBJECTIVE
To investigate the local histologic and immunohistochemical changes in cervical disc herniation, including NO production, and to compare such changes with those in autopsy cases.


BACKGROUND
Very little is known about the histopathologic processes of cervical disc herniation. In addition, no information is available on the level of in vivo NO production in cervical disc herniation.


METHODS
Thirty-six herniated cervical discs obtained from 31 patients were immunohistochemically examined for localization of blood vessels, matrix metalloproteinase (MMP)-3, and inducible NO synthetase (iNOS). We also compared the production of NO, measured by the ESR method, in eight specimens with that of five control discs obtained from fresh cadavers.


RESULTS
The presence of herniated discs correlated with the degeneration of cartilaginous endplate and torn anulus fibrosus. Formation of new blood vessels around the herniated discs was detected, using von Willebrand factor antibody, in seven uncontained hernias and 20 contained hernias. Immunohistochemical studies showed the presence of cells positive for MMP-3 (chondrocytes), iNOS (chondrocytes and granulation tissue) in cervical disc hernias. ESR analysis showed a significantly higher NO production in herniated cervical discs than in disc samples of fresh cadavers.


CONCLUSIONS
Herniated cervical intervertebral disc is characterized by the presence of an inflammatory process associated with neovascularization and increased expression of MMP-3. Production of NO was markedly high in both contained- and uncontained-type hernias.
Furusawa
N
N
Departmenr of Orthopaedic Surgerey, School of Medicine, Fukui Medical University, Fukui, Japan. furusawa@fmsrsa.fukui-med.ac.jp
Baba
H
H
Miyoshi
N
N
Maezawa
Y
Y
Uchida
K
K
Kokubo
Y
Y
Fukuda
M
M
D000328:Adult; D000368:Aged; D002102:Cadaver; D002574:Cervical Vertebrae; D004578:Electron Spin Resonance Spectroscopy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007405:Intervertebral Disc Displacement / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000096:biosynthesis / Q000378:metabolism
D009569:Nitric Oxide