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Effect of Hyperbaric Oxygenation on Intervertebral Disc Degeneration: An In Vivo Study With Sprague-Dawley Rats

Wang, I-Chun, MD; Liu, Hsien-Tao, MD; Yu, Chung-Ming, MD; Whu, Shu-Wen, PhD; Lin, Song-Shu, MS; Su, Chun-I, MD; Chen, Chih-Hwa, MD; Chen, Wen-Jer, MD

doi: 10.1097/BRS.0b013e31827bf6bf
Basic Science

Study Design. An in vivo study was conducted to test the effect of hyperbaric oxygenation (HBO) on intervertebral disc degeneration in Sprague-Dawley rats.

Objective. To observe the changes in intervertebral disc height and levels of glycosaminoglycan, collagen, interleukin-1β (IL-1β), prostaglandin E2 (PGE2), and inducible nitric oxide synthase (iNOS) in degenerated intervertebral discs after HBO therapy.

Summary of Background Data. Although the involvement of IL-1β, PGE-2, NO, and low O2 concentration has been demonstrated in intervertebral disc degeneration, the actual mechanism is not clear. It has been reported that HBO influences changes in IL-1β, PGE-2, NO, and O2 concentration. Previously, a study demonstrated an in vitro positive effect of HBO on the human nucleus pulposus. Thus, an in vivo study in animals was necessary.

Methods. Twelve Sprague-Dawley rats were each injected with chondroitinase ABC in 2 proximal intervertebral discs of the tail. After treating with 100% oxygen at 2.5 atmospheres 2 hours per days for 10 days, the change in disc height was determined by radiography. The amounts of PGE-2, iNOS, glycosaminoglycan, and total collagen in the intervertebral disc were quantified by enzyme-linked immunosorbent assay. Tissue morphology and the distribution of glycosaminoglycan, IL-1β, and iNOS in the intervertebral disc were assessed by histology and immunohistochemistry. The area of IL-1β in the intervertebral discs was quantified using image analysis software.

Results. HBO therapy stopped the decrease in intervertebral disc height, caused an increase in the amount of glycosaminoglycan, and inhibited IL-1β, PGE-2, and iNOS production.

Conclusion. HBO provides a potential treatment modality for intervertebral disc degeneration.

We evaluated the effects of hyperbaric oxygenation (HBO) treatment on disc degeneration induced by injection of chondroitinase into intervertebral discs of rat tails. Our data indicate that HBO therapy prevented in vivo degenerative changes including the decrease in intervertebral disc height, loss of glycosaminoglycan, and increase in levels of interleukin-1β, prostaglandin E2, and inducible nitric oxide synthase. These beneficial effects were compatible with the results of a previous in vitro study. Accordingly, HBO should be considered a potential therapy for disc degeneration.

From the Department of Orthopaedic Surgery and Hyperbaric Oxygen Therapy Center, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Taoyuan, Taiwan

Address correspondence and reprint requests to Shu-Wen Whu, PhD, Department of Orthopaedic Surgery and Hyperbaric Oxygen Therapy Center, Chang Gung Memorial Hospital at Keelung, No. 222, Mai-Chin Rd, Taoyuan, Taiwan. E-mail:

Acknowledgment date: September 20, 2011. First revision date: March 6, 2012. Acceptance date: October 19, 2012.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Chang Gung Memorial Hospital grant funds were received to support this work.

No relevant financial activities outside the submitted work.

© 2013 Lippincott Williams & Wilkins, Inc.