Pre-operative blood test for antibody to nucleus pulposus may distinguish types of lumbar disc herniation.

Summary The types of lumbar disc herniation not only play a key role in planning therapeutic procedure, but also appear to be connected with prognosis. However, it is difficult to distinguish the types preoperatively. To the best of our knowledge, the intervertebral disc is the largest avascular structure in the human body. Once the nucleus pulposus extrudes from the annulus fibrosus or combining with posterior longitudinal ligament, the immune system recognizes it as a foreign body, which may induce the autoimmune reaction ending with production of auto-antibody, that is so-called antibody to nucleus pulposus. The blood test for antibody to nucleus pulposus is ultimately accurate because the result is not relied upon the patient’s complain but specific to herniated nucleus pulposus tissue. If this hypothesis is proved to be correct, it could be possible to improve the accuracy of distinguishing types of lumbar disc herniation just by a pre-operative blood test for antibody to nucleus pulposus.