title: Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs.
abstract: OBJECTIVE
  Lumbar disc degeneration may be associated with intensity of neovascularization in disc herniations. Our study was designed to evaluate how much the severity of histodegeneration is related to the development of neovascularization and to the level of pleiotrophin in the herniated lumbar discs.
  
  
  METHODS
  Surgically excised lumbar disc specimens were obtained from 29 patients with noncontained (i.e., extruding through the posterior longitudinal ligament) and 21 patients with contained disc herniations. The histodegeneration scores and levels of neovascularization were estimated according to semiquantitative analysis in lumbar disc and endplate samples. Immunohistochemical staining were performed to identify the newly formed blood vessels and to detect the presence of pleiotrophin in the specimens.
  
  
  RESULTS
  Higher levels of disc and endplate neovascularity were registered in noncontained herniations. The level of neovascularization was significantly related to the score of histodegeneration in the herniated disc tissues but not in the endplate specimens. Both contained and noncontained herniations had the highest values of histodegeneration in conjunction with the highest level of neovascularization but the relations between neovascularity and degenerative changes remained to be significant only in the group of noncontained herniations. Registration or frequency of pleiotrophin positive cells did not correlate significantly with histodegeneration or level of neovascularization in the disc samples.
  
  
  CONCLUSIONS
  Severe histodegeneration of the lumbar disc herniations is associated with enhanced neovascularization and potentially also spontaneous regression of the herniated tissue.
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, L.Puusepa 8, 51014, Tartu, Estonia, tonu.ratsep@kliinikum.ee.
authors.forename: Tõnu
authors.initials: T
authors.lastname: Rätsep
authors.forename: Ave
authors.initials: A
authors.lastname: Minajeva
authors.forename: Toomas
authors.initials: T
authors.lastname: Asser
mesh_terms: D000328:Adult; D000368:Aged; D002352:Carrier Proteins / Q000032:analysis*; D016207:Cytokines / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007403:Intervertebral Disc / Q000737:chemistry* / Q000473:pathology; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000473:pathology*; D055815:Young Adult
chemical_list: D002352:Carrier Proteins; D016207:Cytokines; C066845:pleiotrophin