European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Transient or persistent alterations in the L5 lumbar nerve root have been described as a complication after the reduction of spondylolistheses. In a retrospective analysis of our own patients, we observed a higher incidence of transient motor and sensomotor deficits after single-sitting anatomic correction of May-erding grade IV anterolistheses and spondyloptoses. These findings are consistent with those of other authors. ⋯ Its course was constantly ventral to the L5 nerve root, which was also adherent to the periosteum of the sacrum distal to this constriction in one-fifth of the specimens. The average pressure exerted on the nerve root during the distraction and translation process was over 30 mmHg in the area of this lumbosacral ligamentous connection, at a distance of greater than 20 mm. When the translation distance was further increased, perineural fatty tissue was discharged, due to increasing perineural pressure.
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Transforming growth factor beta (TGF-beta) is a potent inducer of angiogenesis and fibrogenesis. There is presently little information about the pathophysiological function of TGF-beta in herniated disc tissue. In order to analyze the cellular role and activation of TGF-beta after disc herniation we immunostained frozen material from 38 disc herniation operations and from eight macroscopically normal discs from organ donors. ⋯ For all three antibodies, a statistically significantly (Mann-Whitney test, P = 0.0001) higher number of disc cells showed immunopositivity in the herniated discs. The increase in TGF-beta receptor immunopositivity suggested induction of TGF-beta receptors in herniated discs. Our results support an active regulatory role for TGF-beta in disc cell metabolism.