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RISS 인기검색어
- 검색키워드
- 저자 : Markova Dessislava Z. (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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Correlation of Early Outcomes and Intradiscal Interleukin-6 Expression in Lumbar Fusion Patients
John D. Koerner,Dessislava Z. Markova,Greg D. Schroeder,Christopher L. Antonacci,Joseph Mendelis,Alexander R. Vaccaro,D. Greg Anderson,Chris K. Kepler 대한척추신경외과학회 2020 Neurospine Vol.17 No.1
Objective: To determine if there is correlation between intradiscal levels of interleukin-6 (IL-6) and early outcome measures in patients undergoing lumbar fusion for painful disc degeneration. Methods: Intervertebral disc tissue was separated into annulus fibrosus/nucleus pulposus and cultured separately in vitro in serum-free medium (Opti-MEM). Conditioned media was collected after 48 hours. The concentration of IL-6 was quantified using enzyme-linked immunosorbent assay. Pearson correlation coefficients quantified relationships between IL-6 levels and pre- and postoperative visual analogue scale (VAS) back pain and Oswestry Disability Index (ODI), as well as change in VAS/ODI. Results: Sixteen discs were harvested from 9 patients undergoing anterior lumbar interbody fusion (mean age, 47.4 years; range, 21–70 years). Mean preoperative and 6-month postoperative VAS were 8.1 and 3.7, respectively. Mean preoperative and postoperative ODI were 56.2 and 25.6, respectively. There were significant positive correlations between IL-6 expression and postoperative VAS (ρ=0.38, p=0.048) and ODI (ρ=0.44, p=0.02). No significant correlations were found between intradiscal IL-6 expression and preoperative VAS (ρ=-0.12, p=0.54). Trends were seen associating IL-6 expression and change in VAS/ODI (ρ=-0.35 p=0.067; ρ=-0.34, p=0.08, respectively). A trend associated IL-6 and preoperative ODI (ρ=0.36, p=0.063). Conclusion: The direct association between IL-6 expression and VAS/ODI suggests patients with elevated intradiscal cytokine expression may have worse early outcomes than those with lower expression of IL-6 after surgery for symptomatic disc degeneration.
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Inhibition of Neurogenic Inflammatory Pathways Associated with the Reduction in Discogenic Back Pain
Canseco Jose A.,Levy Hannah A.,Karamian Brian Abedi,Blaber Olivia,Chang Michael,Patel Neil,Curran John,Hilibrand Alan S.,Schroeder Gregory D.,Vaccaro Alexander R.,Markova Dessislava Z.,Surrey David E. 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.6
Study Design: Retrospective cohort study.Purpose: This study aimed to determine whether the initiation of anti-calcitonin gene-related peptide (CGRP inhibitor) medication therapy for migraines was also associated with improvements in back/neck pain, mobility, and function in a patient population with comorbid degenerative spinal disease and migraine.Overview of Literature: CGRP upregulates pro-inflammatory cytokines such as tumor necrosis factor-α, interleukin-6, brain-derived neurotrophic factor, and nerve growth factor in spinal spondylotic disease, which results in disc degeneration and sensitization of nociceptive neurons. Although CGRP inhibitors can quell neurogenic inflammation in migraines, their off-site efficacy as a therapeutic target for discogenic back/neck pain conditions remains unknown.Methods: All adult patients diagnosed with spinal spondylosis and migraine treated with CGRP inhibitors at a single academic institution between 2017 and 2020 were retrospectively identified. Patient demographic and medical data, follow-up duration, migraine severity and frequency, spinal pain, functional status, and mobility before and after the administration of CGRP inhibitors were collected. Paired univariate analysis was conducted to determine significant changes in spinal pain, headache severity, and headache frequency before and after the administration of CGRP inhibitors. The correlation between changes in the spinal pain score and functional or mobility improvement was assessed with Spearman’s rho.Results: In total, 56 patients were included. The mean follow-up time after the administration of CGRP inhibitors was 123 days for spinal pain visits and 129 days for migraine visits. Back/neck pain decreased significantly (<i>p</i> <0.001) from 6.30 to 4.36 after starting CGRP inhibitor therapy for migraine control. As recorded in the spine follow-up notes, 25% of patients experienced a functional improvement in the activities of daily living, and 17.5% experienced mobility improvement while taking CGRP inhibitors. Change in back/ neck pain moderately correlated (ρ=−0.430) with functional improvement but was not correlated with mobility improvement (ρ=−0.052).Conclusions: Patients taking CGRP inhibitors for chronic migraines with comorbid degenerative spinal conditions experienced significant off-target reduction of back/neck pain.
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