title: Influence of variation in the catechol-O-methyltransferase gene on the clinical outcome after lumbar spine surgery for one-level symptomatic disc disease: a report on 176 cases.
abstract: BACKGROUND
  This study was aimed at the evaluation of the relationship between genetic polymorphisms of catechol-O-methyltransferase (COMT) (rs4680:A > G-Val158Met, rs6269:A > G, rs4633:C > T, rs4818:C > G) and pain sensitivity after lumbar discectomy.
  
  
  METHODS
  All patients had one-level symptomatic disc herniation from L3 to S1. The primary data recorded included visual analogue pain scales assessing back and leg pain, Oswestry Disability Questionnaire assessing quality of life and pain intensity, received/filled pre- and postoperatively. Each subject was genotyped for single-nucleotide polymorphism in the COMT gene. Clinical outcome was measured by difference between pre- and postoperative values and those results were analyzed with genetics findings.
  
  
  RESULTS
  Pain intensity was associated with the COMT polymorphism. Carriers of rs6269 AA, rs4633 TT, rs4818 CC, and rs4680 AA genotypes were characterized by the lowest preoperative scores related to pain intensity and lower pain intensity at 1 year after the surgery. The rs4633 CC, rs4680 GG genotypes demonstrated significant clinical improvement in VASBACK score at 1 year after the surgery. Patients with COMT haplotype associated with low metabolic activity of enzyme (A_C_C_G) showed better clinical outcome measured by ODI score and VASBACK score 1 year after surgery. We did not observe any significant correlation between leg pain and single-nucleotide polymorphisms in the COMT gene.
  
  
  CONCLUSIONS
  The results of our study indicate that polymorphism in the COMT gene may play an important role in the mechanism of pain perception, which may have a potential implication for clinical decision-making in the future.
authors.affiliation: Department of Neurosurgery, Medical University of Gdansk, Debinki str. 7, 80-952, Gdansk, Poland, marcin-rut@wp.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Rut
authors.forename: Anna
authors.initials: A
authors.lastname: Machoy-Mokrzyńska
authors.forename: Daniel
authors.initials: D
authors.lastname: Ręcławowicz
authors.forename: Paweł
authors.initials: P
authors.lastname: Słoniewski
authors.forename: Mateusz
authors.initials: M
authors.lastname: Kurzawski
authors.forename: Marek
authors.initials: M
authors.lastname: Droździk
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Safranow
authors.forename: Michalina
authors.initials: M
authors.lastname: Morawska
authors.forename: Monika
authors.initials: M
authors.lastname: Białecka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006239:Haplotypes / Q000235:genetics*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000235:genetics / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002394:Catechol O-Methyltransferase