Elevated Concentration of Hyaluronan in the Cerebrospinal Fluid is a Secondary Marker of Spinal Disorders: Hyaluronan in the Cerebrospinal Fluid in Patients With Spinal Disorders

Background Hyaluronan (HA) was measured in cerebrospinal fluid (CSF) to ascertain the clinical significance of this substance in patients with spinal disorders, a topic that, to the best of our knowledge, has not previously been studied. Methods We examined correlations of CSF HA concentration with age, sex, height, body weight, and spinal disorders. By using a sandwich-binding protein assay, HA was measured in CSF samples obtained from 500 patients aged 12 to 104 years who underwent lumbar spinal anesthesia for surgery, myelography, or CSF examination. These patients were classified into 3 groups: (1) a control group (306 patients with injury or benign tumor of the lower limbs); (2) a cervical disorders group (84 patients with cervical disc herniation, cervical spondylotic myelopathy, or ossification of the posterior longitudinal ligament); and (3) a lumbar disorders group (110 patients with lumbar disc herniation, lumbar spinal canal stenosis tethered cord syndrome, lumbar fracture, or spondylolytic spondylolisthesis). Results CSF HA concentration was found to be positively correlated with age, and was significantly higher in patients with cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament, or lumbar spinal canal stenosis tumor than in the control group. Conclusions CSF HA concentration might be a secondary marker for inflammation in patients with spinal disease.