Genetics May Predict Outcome of Spine Surgery

For lumbar disc disease, COMT polymorphisms, degree of pain relief are related

MONDAY, Nov. 22 (HealthDay News) -- Genetic variation in the pain sensitivity gene catechol-O-methyltransferase (COMT) is associated with success or failure of surgical treatment for lumbar degenerative disc disease (DDD), according to research published in the November issue of The Spine Journal.

Feng Dai, Ph.D., of the University of Pittsburgh, and colleagues conducted a study of 69 patients undergoing surgical treatment for lumbar DDD to determine whether a genetic variation of COMT was associated with pain-related clinical outcome after the procedure. Genotype analysis was performed for five common COMT single nucleotide polymorphisms (SNPs). Measured outcomes were Oswestry Disability Index (ODI) and visual analog scale (VAS) scores for low back pain.

One year post-surgery, single-marker analysis showed that the COMT SNP rs4633 was significantly associated with greater improvement in ODI score (P = .03); individuals homozygous for the less common T allele had the largest improvement in ODI score. A common haplotype, designated ATCA, which had a frequency of 39.3 percent in the study population, was also associated with greater improvement in ODI score (P = .046). A trend for an association between SNP rs4633 and greater improvement in VAS score was seen, but was not statistically significant.

"Although it would not be appropriate to put all the emphasis on pain genes, the article does highlight, for the first time in patients with back pain, that the outcome of surgery may be related to genes," writes the author of an accompanying commentary. "It would also be interesting to find out whether such a group of surgical patients is already pre-selected by their genetic makeup, in that those who were less sensitive to pain may not have elected for surgery, and therefore accounting for the weak differences shown."

Several authors disclosed financial relationships with the biotechnology, medical device, and pharmaceutical industries.

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