• John D Koerner, Dessislava Z Markova, Sanjay Yadla, Joseph Mendelis, Alan Hilibrand, Alexander R Vaccaro, Makarand V Risbud, Todd J Albert, D Greg Anderson, and Christopher K Kepler.
• *Department of Orthopaedics, Thomas Jefferson University, Philadelphia, PA †Rothman Institute, Philadelphia, PA; and ‡Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA.
• Spine. 2014 Nov 1;39(23):1917-23.

Study DesignLaboratory study.ObjectiveTo evaluate the differential gene expression of cytokines and growth factors in anterior versus posterior annulus fibrosus (AF) intervertebral disc (IVD) specimens.Summary Of Background DataHistological analysis has demonstrated regional differences in vascular and neural ingrowth in the IVD, and similar differences may exist for cytokine and growth factor expression in patients with degenerative disc disease (DDD). Regional expression of these cytokines may also be related to the pain experienced in DDD.MethodsIVD tissue was obtained from patients undergoing anterior lumbar interbody fusion surgery for back pain with radiological evidence of disc degeneration. For a control group, the discs of patients undergoing anterior lumbar discectomy for degenerative scoliosis were obtained as well. The tissue was carefully removed and separated into anterior and posterior AF. After tissue processing, an antibody array was completed to determine expression levels of 42 cytokines and growth factors.ResultsNine discs from 7 patients with DDD and 5 discs from 2 patients with scoliosis were analyzed. In the DDD group, there were 10 cytokines and growth factors with significantly increased expression in the posterior AF versus the anterior AF ([interleukin] IL-4, IL-5, IL-6, M-CSF, MDC, tumor necrosis factor β, EGF, IGF-1, angiogenin, leptin). In the scoliosis group, only angiogenin and PDGF-BB demonstrated increased expression in the posterior AF. No cytokines or growth factors had increased expression in the anterior AF compared with posterior AF.ConclusionThe posterior AF expresses increased levels of cytokines and growth factors compared with the anterior AF in patients with DDD. This differential expression may be important for targeting treatment of painful IVDs.Level Of EvidenceN/A.

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