Metabolic changes in the cerebrospinal fluid of patients with lumbar disc herniation or spinal stenosis.
Metabolite levels in cerebrospinal fluid from patients with lower back pain and/or sciatica caused by disc herniation or spinal stenosis were compared with levels in pain-free controls using proton magnetic resonance spectroscopy. Significant differences for several metabolites were found in patients with pain compared with controls. Most changes were found in the group with disc herniation, including reductions in glucose, alanine, and lactate, suggesting increased aerobic metabolism in this group. There was a significant reduction in the level of glucose in the group with spinal stenosis irrespective of whether the patients were compared with the whole control group (age-weighted) or with age-matched controls. Additionally, inositol and creatinine were reduced in patients with disc herniation. Inositol was also significantly reduced in the spinal stenosis group when age matched to controls. Insofar as the levels of pain recorded by the patients with lumbar pathology were similar in the two groups, it seems more likely that the reductions in metabolite levels recorded in the group with disc herniations are related to disc pathology rather than the perception of pain. However, the possibility that pain perception contributes to the metabolic changes cannot be excluded.
Gårseth
Mari
M
Department of Clinical Neurosciences, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. mari.garseth@medisin.ntnu.no
Sonnewald
Ursula
U
White
Linda R
LR
Rød
Marianne
M
Nygaard
Øystein
Ø
Zwart
John-Anker
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D003404:Creatinine / Q000134:cerebrospinal fluid; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D007294:Inositol / Q000134:cerebrospinal fluid; D007405:Intervertebral Disc Displacement / Q000134:cerebrospinal fluid*; D007773:Lactates / Q000134:cerebrospinal fluid; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000134:cerebrospinal fluid; D013130:Spinal Stenosis / Q000134:cerebrospinal fluid*
D007773:Lactates; D007294:Inositol; D003404:Creatinine; D005947:Glucose