The Elevated Serum Level of IFN-γ in Patients with Failed Back Surgery Syndrome Remains Unchanged after Spinal Cord Stimulation

الملخص EN

Objectives.

We investigated the influence of spinal cord stimulation (SCS) on IFN-γ, IL-1β, IL-6, TNF-α, IL-10, and TGF-β serum levels in failed back surgery syndrome (FBSS) patients.

The study will try to give new insights into the mechanism of SCS action and the role of IFN-γ and other cytokines in neuropathic pain (NP) development.

Materials and Methods.

Clinical and biochemical assessment was conducted in four groups of patients: group 0 consisted of 24 FBSS patients qualified to SCS therapy, group 1 included 17 patients who were one month after implantation, group 2 featured 12 patients who were 3 months after the implantation, and group C (the control group) with no NP.

Clinical status was assessed with the use of Numeric Rating Scale (NRS), the Pain Rating Index of McGill Pain Questionnaire (SF-MPQ), the Oswestry Disability Index (ODI), and Beck Depression Inventory (BDI).

The plasma concentrations of IFN-γ were ascertained by an immunoenzymatic method.

Results.

We found a significant difference between the patients before SCS and controls’ serum level of IFN-γ.

Similarly, a significantly higher level of TNF-α and significantly lower level of IL-10 in FBSS patients than controls were observed.

The significant differences were not observed between SCS patients 3 months after the procedure and controls’ serum level of IFN-γ and other cytokines.

We noticed a positive correlation between IFN-γ concentration with NRS back value before SCS and positive correlation between IFN-γ concentration after SCS with NRS leg value before SCS.

Higher IFN-γ concentrations accompanied higher NRS values.

Levels of TGF-β and IL-10 may correlate with physical ability and depressive behavior.

Conclusions.

SCS did not influence serum cytokine levels significantly.

Serum concentration of IFN-γ may be recognized as an occasional pain factor because of its significantly higher level in FBSS patients versus controls and higher IFN-γ value accompanying higher pain intensity.