Prostaglandin E2 Content in Herniated Lumbar Disc Disease

Study Design A prospective series of biochemical assays for prostaglandin E2 content in symptomatic herniated lumbar disc specimens. Objectives To help clarify the pathogenesis of lumbar radiculopathy. Summary of Background Data Three recent studies have shown elevated levels of prostaglandin E2 in intervertebral disc herniations. None of these studies correlated symptoms with prostaglandin E2 levels. Methods Twenty-four disrupted disc samples were purified by a standard solid phase extraction method and analyzed for prostaglandin E2 with an enzyme-linked immunosorbent assay. Clinical and anatomic correlations were sought with analysis of variance and t test. Results Sequestered discs tended to be associated with a higher prostaglandin E2 content than extruded discs, which in turn, tended to be associated with higher prostaglandin E2 content than protruded ones. A positive straight leg raising test appeared to be associated with a higher prostaglandin E2 content than a negative test. Conclusions Prostaglandin E2 appears to mediate some of the inflammatory effects of lumbar disc herniation. An intact anulus may provide some protection against this stimulus.