Chronic low back pain due to lumbar spinal stenosis (LSS) is common, costly, mechanistically complex, and clinically challenging. However, the factors and mechanisms causing and mediating chronic pain induced by cauda equina compression remain unclear. Here, we examined the role of cyclooxygenase (COX)-2 in infiltrated macrophages, a key mediator of inflammation, in chronic neuropathic pain by LSS using an animal model. LSS was induced in adult male rats by cauda equina compression procedure using a silicone block within the epidural spaces of L5-L6 vertebrae. Locomotor deficit was observed after compression and mechanical allodynia was developed progressively for 4 weeks after injury. A number of macrophage were also infiltrated into the spinal parenchyma and cauda equina and COX-2 was expressed in infiltrated macrophages at 28 days after cauda equina compression. The administration of COX-2 inhibitors, celecoxib and MPO-0029, significantly alleviated LSS-induced chronic mechanical allodynia and inhibited the mRNA expression of inflammatory mediators such as tnf-α, Il-1β, il-6, and inos. Furthermore, COX-2 inhibitors significantly reduced prostaglandin E2 production. These results demonstrated the role of COX-2 in LSS-induced chronic neuropathic pain and suggest that the regulation of COX-2 can be considered as a therapeutic target to relive neuropathic pain.
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http://dx.doi.org/10.1016/j.intimp.2019.105738 | DOI Listing |
Cureus
December 2024
Neurosurgery, Al-Azhar University, Giza, EGY.
Intradural disc herniation (IDDH) is a rare condition, accounting for less than 0.5% of herniated disc cases, primarily affecting the lumbar region and often presenting with severe nerve compression or cauda equina syndrome. This paper presents the case of a 60-year-old female with a history of hypertension, dyslipidemia, stroke, and hypothyroidism, who arrived with severe lower back pain, lower limb weakness, and urinary retention.
View Article and Find Full Text PDFSpine (Phila Pa 1976)
January 2025
Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Study Design: Systematic review and meta-analysis.
Objective: To investigate evidence on the prevalence and timeline of RTW after lumbar microdiskectomy.
Summary Of Background Data: While lumbar microdiskectomy is a widely used and well-studied procedure, there is lack of evidence on the postoperative prevalence and schedule of return to work after this type of surgery.
Sci Rep
January 2025
Department of Orthopedics, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, PR, China.
Currently, Unilateral biportal endoscopy is widely used in the surgical treatment of lumbar spinal stenosis. To investigate the feasibility of bilateral synchronous UBE to unilateral laminotomy and bilateral decompression(BS-UBE-ULBD) for treating two-level lumbar spinal stenosis (LSS). Sixty-four patients with two-level lumbar spinal stenosis (LSS) treated with BS-UBE-ULBD from October 2022 to January 2024 were retrospectively analyzed.
View Article and Find Full Text PDFWorld Neurosurg
January 2025
Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, M6 8HD, Manchester, England, United Kingdom.
Objective: Cauda Equina Syndrome (CES) poses significant neurological risks if untreated. Diagnosis relies on clinical and radiological features. As the symptoms are often non specific and common, the diagnosis is usually made after a MRI scan.
View Article and Find Full Text PDFClin Case Rep
January 2025
Pediatric Neurology Department, Pediatric Neurology Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.
Intrathecal methotrexate can cause cauda equina syndrome in pediatric ALL patients, as demonstrated in this rare case of an 8-year-old boy. Symptoms included progressive limb weakness and urinary retention. Early recognition, prompt discontinuation of the offending agent, and multidisciplinary management are crucial.
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