Abstract
Background
The purpose of this study was to investigate saliva cortisol levels of Chinese patients with discogenic sciatica and to clarify the relationship between psychosocial factors and saliva cortisol levels. We also intended to elucidate the effect of different types of cortisol secretion on the prognosis of lumbar discectomy.
Methodology
37 patients with discogenic sciatica, 18 patients with chronic somatic pain and 20 healthy pain-free subjects were included in this analysis. The Japanese Orthopedic Association (JOA) score was used to evaluate functional ability. The diurnal patterns of cortisol secretion of the three groups were assessed. The correlation between cortisol secretion level and preoperative psychosocial surveys was assessed.
Results
The patients with chronic somatic pain showed a significantly low level of cortisol secretion during the declining period and an obvious decline from the peak. The change in JOA score after surgery was positively correlated with saliva cortisol concentration during the peak period and the declining period, and negatively correlated with the magnitude of cortisol change throughout the day. Psychosocial factors were correlated with improved JOA scores. These factors are also interrelated to the cortisol secretion level.
Conclusions
Cortisol secretion level is a correlative physiological mechanism for the effect of psychosocial factors on the prognosis of lumbar discectomy.
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References
Loupasis G.A., Stamos K., Katonis P.G., Sapkas G., Korres D.S., Hartofilakidis G., Seven- to 20-year outcome of lumbar discectomy, Spine (Phila Pa 1976), 1999, 24, 2313–2317
Yorimitsu E., Chiba K., Toyama Y., Hirabayashi K., Long-term outcomes of standard discectomy for lumbar disc herniation: a follow-up study of more than 10 years, Spine (Phila Pa 1976), 2001, 26, 652–657
Anderson P.A., McCormick P.C., Angevine P.D., Randomized controlled trials of the treatment of lumbar disk herniation: 1983–2007, J. Am. Acad. Orthop. Surg., 2008, 16, 566–573
Gotfryd A., Avanzi O., A systematic review of randomised clinical trials using posterior discectomy to treat lumbar disc herniations, Int. Orthop., 2009, 33, 11–17
Carragee E.J., Psychological screening in the surgical treatment of lumbar disc herniation, Clin. J. Pain, 2001, 17, 215–219
Rainville J., Ahern D.K., Phalen L., Altering beliefs about pain and impairment in a functionally oriented treatment program for chronic low back pain, Clin. J. Pain, 1993, 9, 196–201
Clauw D.J., Williams D., Lauerman W., Dahlman M., Aslami A., Nachemson A.L., Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain, Spine (Phila Pa 1976), 1999, 24, 2035–2041
Malmivaara A., Hakkinen U., Aro T., Heinrichs M.L., Koskenniemi L., Kuosma E., The treatment of acute low back pain—bed rest, exercises, or ordinary activity?, N. Engl. J. Med., 1995, 332, 351–355
Klenerman L., Slade P.D., Stanley I.M., Pennie B., Reilly J.P., Atchison L.E., The prediction of chronicity in patients with an acute attack of low back pain in a general practice setting, Spine (Phila Pa 1976), 1995, 20, 478–484
Vlaeyen J.W., Kole-Snijders A.M., Boeren R.G., van Eek H., Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance, Pain, 1995, 62, 363–372
Al-Obaidi S.M., Nelson R.M., Al-Awadhi S., Al-Shuwaie N., The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain, Spine (Phila Pa 1976), 2000, 25, 1126–1131
Takeyachi Y., Konno S., Otani K., Yamauchi K., Takahashi I., Suzukamo Y., Correlation of low back pain with functional status, general health perception, social participation, subjective happiness, and patient satisfaction, Spine (Phila Pa 1976), 2003, 28, 1461–1466
Junge A., Dvorak J., Ahrens S., Predictors of bad and good outcomes of lumbar disc surgery. A prospective clinical study with recommendations for screening to avoid bad outcomes, Spine (Phila Pa 1976), 1995, 20, 460–468
Hagg O., Fritzell P., Ekselius L., Nordwall A., Predictors of outcome in fusion surgery for chronic low back pain. A report from the Swedish Lumbar Spine Study, Eur. Spine J., 2003, 12, 22–33
Reiso H., Nygard J.F., Jorgensen G.S., Holanger R., Soldal D., Bruusgaard D., Back to work: predictors of return to work among patients with back disorders certified as sick: a two-year follow-up study, Spine (Phila Pa 1976), 2003, 28, 1468–1473
Anderson P.A., Schwaegler P.E., Cizek D., Leverson G., Work status as a predictor of surgical outcome of discogenic low back pain, Spine (Phila Pa 1976), 2006, 31, 2510–2515
den Boer J.J., Oostendorp R.A., Beems T., Munneke M., Oerlemans M., Evers A.W., A systematic review of bio-psychosocial risk factors for an unfavourable outcome after lumbar disc surgery, Eur. Spine J., 2006, 15, 527–536
Heneweer H., Aufdemkampe G., van Tulder M.W., Kiers H., Stappaerts K.H., Vanhees L., Psychosocial variables in patients with (sub)acute low back pain: an inception cohort in primary care physical therapy in The Netherlands, Spine (Phila Pa 1976), 2007, 32, 586–592
Burke J.G., RW G.W., Conhyea D., McCormack D., Dowling F.E., Walsh M.G., Human nucleus pulposis can respond to a pro-inflammatory stimulus, Spine (Phila Pa 1976), 2003, 28, 2685–2693
Ozaktay A.C., Kallakuri S., Takebayashi T., Cavanaugh J.M., Asik I., DeLeo J.A., Effects of interleukin-1 beta, interleukin-6, and tumor necrosis factor on sensitivity of dorsal root ganglion and peripheral receptive fields in rats, Eur. Spine. J., 2006, 15, 1529–1537
Johansson A.C., Gunnarsson L.G., Linton S.J., Bergkvist L., Stridsberg M., Nilsson O., Pain, disability and coping reflected in the diurnal cortisol variability in patients scheduled for lumbar disc surgery, Eur. J. Pain, 2008, 12, 633–640
Geiss A., Varadi E., Steinbach K., Bauer H.W., Anton F., Psychoneuroimmunological correlates of persisting sciatic pain in patients who underwent discectomy, Neurosci. Lett., 1997, 237, 65–68
Perry M.G., Kirwan J.R., Jessop D.S., Hunt L.P., Overnight variations in cortisol, interleukin 6, tumour necrosis factor alpha and other cytokines in people with rheumatoid arthritis, Ann. Rheum. Dis., 2009, 68, 63–68
Tak L.M., Bakker S.J., Rosmalen J.G., Dysfunction of the hypothalamic-pituitary-adrenal axis and functional somatic symptoms: a longitudinal cohort study in the general population, Psychoneuroendocrinology, 2009, 34, 869–877
Lamberts S.W., Bons E.G., Bruining H.A., Different sensitivity to adrenocorticotropin of dispersed adrenocortical cells from patients with Cushing’s disease with macronodular and diffuse adrenal hyperplasia, J. Clin. Endocrinol. Metab., 1984, 58, 1106–1110
Glass A.R., Zavadil A.P. 3rd, Halberg F., Cornelissen G., Schaaf M., Circadian rhythm of serum cortisol in Cushing’s disease, J. Clin. Endocrinol. Metab., 1984, 59, 161–165
Geiss A., Rohleder N., Kirschbaum C., Steinbach K., Bauer H.W., Anton F., Predicting the failure of disc surgery by a hypofunctional HPA axis: evidence from a prospective study on patients undergoing disc surgery, Pain, 2005, 114, 104–117
Aardal E., Holm A.C., Cortisol in saliva—reference ranges and relation to cortisol in serum, Eur. J. Clin. Chem. Clin. Biochem., 1995, 33, 927–932
Papanicolaou D.A., Mullen N., Kyrou I., Nieman L.K., Nighttime salivary cortisol: a useful test for the diagnosis of Cushing’s syndrome, J. Clin. Endocrinol. Metab., 2002, 87, 4515–4521
Ljubijankic N., Popovic-Javoric R., Sceta S., Sapcanin A., Tahirovic I., Sofic E., Daily fluctuation of cortisol in the saliva and serum of healthy persons, Bosn. J. Basic Med. Sci., 2008, 8, 110–115
O’Connor D.B., Hendrickx H., Dadd T., Elliman T.D., Willis T.A., Talbot D., et al., Cortisol awakening rise in middle-aged women in relation to psychological stress, Psychoneuroendocrinology. 2009, 34, 1486–1494
Levy D., Kainz V., Burstein R., Strassman A.M., Mast cell degranulation distinctly activates trigemino-cervical and lumbosacral pain pathways and elicits widespread tactile pain hypersensitivity, Brain Behav Immun., 2012, 26, 311–317
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Yan, CN., Wang, H., Peng, M. et al. The effect of different types of cortisol secretion on the prognosis of lumbar discectomy. cent.eur.j.biol. 8, 819–827 (2013). https://doi.org/10.2478/s11535-013-0215-8
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DOI: https://doi.org/10.2478/s11535-013-0215-8