title: Role of Expression of Inflammatory Mediators in Primary and Recurrent Lumbar Disc Herniation.
abstract: OBJECTIVE
  To assess role of some inflammatory mediators in patients with primary and recurrent lumbar disc herniation. Expression of IL-6, transforming growth factor (TGF)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) have been shown to be more intense in the primary group than the recurrent goup, but this mediators may be important aspects prognostic.
  
  
  METHODS
  19 patients underwent primary and revision operations between June 1, 2009 and June 1, 2014, and they were included in this study. The 19 patients' intervertebral disc specimens obtained from the primary procedures and reoperations were evaluated. Expression of IL-6, TGF-1, IGF-1, and BAX were examined immunohistochemically in the 38 biopsy tissues obtained from the primary and recurrent herniated intervertebral discs during the operation.
  
  
  RESULTS
  For IL-6 expression in the intervertebral disc specimens, there was no difference between the groups. The immunohistochemical study showed that the intervertebral disc specimens in the primary group were stained intensely by TGF-1 compared with the recurrent group. Expression of IGF-1 in the primary group was found moderate. In contrast, in the recurrent group of patients was mild expression of IGF-1. The primary group intervertebral disc specimens were stained moderately by BAX compared with the recurrent group.
  
  
  CONCLUSIONS
  The results of our prognostic evaluation of patients in the recurrent group who were operated due to disc herniation suggest that mediators may be important parameters.
authors.affiliation: Department of Neurosurgery, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Yasar
authors.initials: Y
authors.lastname: Dagistan
authors.affiliation: Department of Pathology, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Cukur
authors.affiliation: Department of Radiology, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Dagistan
authors.affiliation: Department of Neurosurgery, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Gezici
keywords: Disc herniation; Immunohistochemical; Inflammatory mediators