title: Clinical significance of cerebrospinal fluid nitric oxide concentrations in degenerative cervical and lumbar diseases.
abstract: In animal models of degenerative lumbar disease, inducible nitric oxide synthase (iNOS) is expressed in macrophages and Schwann cells following compression of the cauda equina. We previously reported that NO metabolites (nitrite plus nitrate: [NOx]) in the cerebrospinal fluid (CSF) correlate with postoperative pain relief in patients with degenerative lumbar disease and with neurologic recovery rate postoperatively or after conservative treatment in patients with spinal cord injury. The objective of the present study was to examine the relationship between [NOx] and neurologic severity, and recovery in degenerative cervical and lumbar diseases. Two hundred fifty-seven cases, including 85 patients with cervical compression myelopathy (CCM), 25 with cervical disc herniation (CDH), 70 with lumbar canal stenosis (LCS), and 77 with lumbar disc herniation (LDH), were examined. The CSF [NOx] was measured using the Griess method. Severity of neurologic impairment and clinical recovery was assessed using the Japanese Orthopedic Association score and Hirabayashi's method. [NOx] in CCM and LCS, but not CDH and LDH groups, was significantly higher than that in controls, and correlated with postoperative recovery rates, but not with preoperative neurologic severity. [NOx] significantly correlated with neurologic recovery following surgery for CCM and LCS.
authors.affiliation: Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1-757, Niigata 951-8510, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Denda
authors.forename: Shinji
authors.initials: S
authors.lastname: Kimura
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Yamazaki
authors.forename: Noboru
authors.initials: N
authors.lastname: Hosaka
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takano
authors.forename: Kenji
authors.initials: K
authors.lastname: Imura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yajiri
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000134:cerebrospinal fluid* / Q000503:physiopathology* / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000134:cerebrospinal fluid / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000134:cerebrospinal fluid*; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000134:cerebrospinal fluid / Q000503:physiopathology / Q000601:surgery; D013130:Spinal Stenosis / Q000134:cerebrospinal fluid / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
chemical_list: D009569:Nitric Oxide