Tumor Necrosis Factor-α-Immunoreactive Cells in Nucleus Pulposus in Adolescent Patients With Lumbar Disc Herniation

Study Design. Immunohistochemistry for tumor necrosis factor (TNF)-alpha in nucleus pulposus of adolescent patients with lumbar disc herniation. Objective. To examine whether an inflammatory cytokine is expressed in the nucleus pulposus of adolescent patients with lumbar disc herniation. Summary of Background Data. TNF alpha is thought to play a crucial role in the radicular pain caused by lumbar disc herniation in adult patients. However, the expression of TNF alpha in the nucleus pulposus of adolescent patients with lumbar disc herniation has not been explored. Methods. Five samples of nucleus pulposus from adolescent patients with lumbar disc herniation (age, 12-16 yr; n = 5) or controls requiring surgery for other back problems (age, 12-16 yr; n = 4; nonpainful scoliosis) were harvested during surgery. Nucleus pulposus specimens were immunostained using TNF alpha antibodies and immunostained cells in the nucleus pulposus were counted. We compared the expression of TNF alpha between the 2 groups. Results. In patients with lumbar disc herniation, more TNF alpha-immunoreactive cells were seen in the nucleus pulposus in comparison with patients with nonpainful scoliosis (P < 0.01). Conclusion. The results suggest that TNF alpha may play a role in adolescent patients with lumbar disc herniation. The TNF alpha expression may be related with disc degeneration and pain in adolescent patients with lumbar disc herniation.