The inflammatory response in the regression of lumbar disc herniation.
Carla CunhaAna J SilvaPaulo PereiraRui VazRaquel M GonçalvesMário A BarbosaPublished in: Arthritis research & therapy (2018)
Lumbar disc herniation (LDH) is highly associated with inflammation in the context of low back pain. Currently, inflammation is associated with adverse symptoms related to the stimulation of nerve fibers that may lead to pain. However, inflammation has also been indicated as the main factor responsible for LDH regression. This apparent controversy places inflammation as a good prognostic indicator of spontaneous regression of LDH. This review addresses the molecular and cellular mechanisms involved in LDH regression, including matrix remodeling and neovascularization, in the scope of the clinical decision on conservative versus surgical intervention. Based on the evidence, a special focus on the inflammatory response in the LDH context is given, particularly in the monocyte/macrophage role. The phenomenon of spontaneous regression of LDH, extensively reported in the literature, is therefore analyzed here under the perspective of the modulatory role of inflammation.
Keyphrases
- inflammatory response
- oxidative stress
- randomized controlled trial
- minimally invasive
- chronic pain
- lipopolysaccharide induced
- systematic review
- adipose tissue
- dendritic cells
- multidrug resistant
- computed tomography
- emergency department
- pain management
- endothelial cells
- vascular endothelial growth factor
- depressive symptoms
- decision making
- diabetic retinopathy
- peripheral nerve