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Morphological Alteration and TGF-β1 Expression in Multifidus with Lumbar Disc Herniation
Dan Pan1,2, Zhicheng Zhang1,3, Dayong Chen2
1The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong China.
Indian Journal of Orthopaedics
|September 21, 2020
Summary
Lumbar disc herniation (LDH) causes multifidus muscle atrophy and fibrosis, indicated by reduced muscle fiber area and increased collagen. Transforming growth factor-beta 1 (TGF-β1) expression is elevated in affected multifidus muscles, potentially driving fibrosis.
Area of Science:
- Spinal surgery
- Orthopedics
- Regenerative medicine
Background:
- Lumbar disc herniation (LDH) can theoretically cause paraspinal muscle atrophy, but multifidus morphological changes remain debated.
- Transforming growth factor-beta 1 (TGF-β1) is crucial in fibrosis but its role in multifidus muscle fibrosis is unstudied.
Purpose of the Study:
- To investigate multifidus muscle morphology in LDH patients.
- To explore the relationship between multifidus fibrosis and TGF-β1 expression.
Main Methods:
- 46 LDH patients were grouped by symptom duration (less than 6 months to over 24 months).
- Bilateral multifidus specimens were analyzed for morphological changes.
- TGF-β1 expression was assessed using immunohistochemistry and immunofluorescence.
Main Results:
- LDH led to decreased multifidus cross-sectional area and muscle fiber atrophy on the involved side.
- Significant fibrosis (decreased myofiber to collagen ratio) was observed in longer-duration LDH groups (12-24 and >24 months).
- TGF-β1 expression was significantly higher in the involved multifidus muscles, particularly in groups with longer symptom duration.
Conclusions:
- Nerve root compression from LDH induces multifidus atrophy, fibrosis, and elevated TGF-β1.
- Increased TGF-β1 expression may contribute to the progression of multifidus fibrosis in LDH patients.
