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.