Abstract:

OBJECTIVE: To observe peripheral T lymphocytes changes of patients with lumbar disc herniation, and investigate the relationship between the type of herniation, signs and T lymphocyte subsets.
METHODS: Blood samples from 49 patients with single-level lumbar intervertebral disc herniation were collected from General Hospital of Tianjin Medical University from January to October 2008, including 26 males and 23 females. There were 22 cases of L4-5 and 27 cases of L5S1. In the straight leg raising (SLR) test before treatment, 34 cases were positive and 15 were negative. According to the position of intervertebral disc observed in operation, the patients were divided into ruptured disc herniation (RDH, n=30) and degenerative disc herniation (DDH, n=19) groups. In addition, blood samples from 20 healthy blood donors were collected as control group. T lymphocytes subsets were detected by flow cytometry.
RESULTS: The levels of CD3⁺ , CD4⁺ , and CD4⁺ /CD8⁺ in RDH group were significantly higher than control group (P < 0.05), and the levels of CD8⁺ in RDH group were significantly lower than control group (P < 0.05). The levels of CD4⁺ and CD4⁺ /CD8⁺ in positive SLR test group were significantly higher than patients with negative results, but significantly lower levels of CD8⁺ was found in positive group than negative group (P < 0.05). The positive rate of SLR test in RDH group was significantly higher than that of SLR testing in DDH group.
CONCLUSION: Changes of T lymphocyte subsets in peripheral blood were found after herniation of lumbar intervertebral disc. T lymphocytes mediated immune response may play an important role in the occurrence and development of signs in patients with herniated lumbar intervertebral disc. The SLR test may help to confirm that the disc herniation may cause nerve root impairment by mechanical loading or inflammatory stimulus.