AI Article Synopsis
- Reoperation is frequently needed for patients with degenerative lumbar spine diseases, leading to worse outcomes over time, and LPC in cerebrospinal fluid may help identify neuropathic pain related to lumbar spinal canal stenosis (LSCS).
- In a multi-site study, researchers collected CSF from patients with LSCS and persistent spinal pain syndrome to analyze six LPC species using advanced mass spectrometry techniques.
- Results showed that LPC levels were significantly higher in the LSCS group, with four species providing high sensitivity for distinguishing LSCS, suggesting LPC measurement could enhance current diagnostic protocols and assist surgical decision-making.
Article Abstract
Background: Reoperation, sometimes multiple, is common with progressively worse outcomes in patients with degenerative lumbar spine diseases. Lysophosphatidylcholine (LPC), a precursor of lysophosphatidic acid, in the cerebrospinal fluid (CSF) is a possible biomarker for neuropathic pain and discriminating neuropathic pain caused by lumbar spinal canal stenosis (LSCS) from other etiologies. This study aimed to explore this possible use of LPC species in the CSF.
Methods: Patients with LSCS (n = 137) and persistent spinal pain syndrome (n = 22) were subjected in this multi-site observational study. The CSF was collected by lumbar puncture. Using liquid chromatography-tandem mass spectrometry, we measured 6 LPC species, (16:0), (18:0), (18:1), (18:2), (20:4), and (22:6), in the CSF. We compared the LPC values between the groups and determined the cutoff levels that could efficiently discriminate the groups with high accuracy.
Results: The levels of all measured LPC species were significantly higher in the LSCS group than the persistent spinal pain syndrome group. Four LPC species demonstrated more than 0.80 area under the curve obtained from the receiver operating characteristic curve analysis. Although the specificity of cutoff levels for the 6 LPC species was low to moderate, their sensitivity was consistently high.
Conclusions: The existing diagnostic protocols combining physical examinations and morphological imaging studies for lumbar spinal pain have limited sensitivity. Measuring LPC species in the CSF is a promising objective laboratory test and could be suitable for detecting the presence of lumbar spinal stenosis and can help indications for surgery.
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| http://dx.doi.org/10.1016/j.wneu.2023.12.148 | DOI Listing |
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