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Prostaglandin production after experimental discectomy
J T Robertson1, G V Huffmon, L B Thomas
1Department of Neurosurgery, University of Tennessee, Memphis, USA.
Spine
|August 1, 1996
Summary
Discectomy significantly increases prostaglandin synthesis in dogs for 24 hours, with levels returning to normal afterward. This suggests a chemical, not healing, response to disc removal.
Area of Science:
- Spinal surgery
- Prostaglandin synthesis
- Inflammation
Background:
- Degenerative disc disease shows high phospholipase A2 activity.
- Phospholipase A2 may cause inflammation by releasing arachidonic acid.
- Prostaglandins (PGI2, PGE2) are algesic eicosanoids derived from arachidonic acid.
Purpose of the Study:
- To measure prostaglandin levels in lumbar epidural fluid after discectomy.
- To compare prostaglandin levels in discectomy sites versus non-discectomy sites and subcutaneous tissue.
Main Methods:
- Dogs underwent discectomy, with lumbar epidural fluid collected via indwelling catheters.
- Fluid was sampled daily for 14 days from discectomy, non-discectomy, and subcutaneous sites.
- Radioimmunoassay was used to analyze concentrations of PGE2 and 6-keto PGF1(alpha) (a PGI2 metabolite).
Main Results:
- Concentrations of 6-keto PGF1(alpha) and PGE2 were significantly higher in the discectomy area within 24 hours.
- Prostaglandin levels in the discectomy site rapidly decreased, showing no significant difference from non-discectomy sites after 48 hours.
- Prostaglandin levels in epidural fluid generally decreased over two weeks.
Conclusions:
- Discectomy is associated with a significant, short-term increase in prostaglandins known to cause pain.
- The rapid decrease suggests the initial prostaglandin surge is linked to chemical factors like phospholipase A2, rather than wound healing.