Analysis of serum biomarkers to predict the neurological prognosis in spinal degenerative disorders

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K20072
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Orthopaedic surgery
• Research Institution: Toho University
• Principal Investigator: TAKAHASHI Hiroshi 東邦大学, 医学部, 講師 (80597047)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 圧迫性脊髄症 / 腰部脊柱管狭窄症 / バイオマーカー / 血中酸化ストレス

Outline of Final Research Achievements

We conducted an observational study to evaluate serum levels of oxidative stress markers (Reactive Oxygen Metabolites: ROM) as one of the candidates to predict the neurological prognosis in spinal degenerative disorders.
In compression myelopathy, ROM increased in severity in patients with acutely worsening myelopathy that suggest that postsurgical neurological recovery is influenced by servere oxidative stress in acute worsening myelopathy. In addition, ROM did not decrease but increased at 3 months after surgery despite the favorable neurological improvement observed. Serum oxidative stress markers were higher and remained elevated in cases complicated with C5 palsy.
On the other hands, in lumbar degenerative disorders, elevated ROM before surgery gradually improved within 1 year after surgery. The clinical results suggest that neurogenic oxidative stress can be mitigated by surgery and residual oxidative stress reflects poor surgical outcomes.

Free Research Field

脊椎脊髄外科

Academic Significance and Societal Importance of the Research Achievements

脊椎変性疾患における血清中バイオマーカー候補として、血中酸化ストレス値を測定し、手術後1年までの経時的変化、臨床成績との関係について解析した。
圧迫性脊髄症では、急性増悪期にROM高値だと手術成績が不良となり、C5麻痺合併例でROMは特に高値を取り、血中酸化ストレスが圧迫性脊髄症の病態、手術成績に影響を与えることが判明した。
腰部脊柱管狭窄症例では、術前に上昇したROMが手術後1年かけて緩徐に改善し、ROM改善不良例ではADL改善が不良となり、血中酸化ストレスが腰部脊柱管狭窄症でも病態、手術成績に関与することが判明した。