Intervertebral disc degeneration (IDD) is a common chronic inflammatory degenerative disease that causes lower back pain. However, the underlying mechanisms of IDD remain unclear. Ferroptosis suppressor protein 1 (FSP1) is a newly identified suppressor for ferroptosis. This study aims to investigate the role of FSP1 in IDD. Nucleus pulposus (NP) tissues in humans were collected and NP cells from rats were isolated to detect FSP1 expression pattern. The relationship between FSP1-mediated ferroptosis and apoptosis was identified using FSP1 inhibitor iFSP1. RNA sequencing was utilized to seek downstream molecules and related signaling pathways. Moreover, both exogenous recombinant FSP1 protein and endogenous small interfering RNA were implemented in this study to clarify the role of FSP1 in tumor necrosis factor-alpha (TNFα)-mediated NP cell apoptosis. Ultimately, the underlying mechanisms of FSP1-related signaling pathway in IDD were uncovered both in vitro and in vivo. As a result, FSP1 was up-regulated in human degenerative NP tissues and after TNFα stimulation. FSP1 inhibition by iFSP1 fails to trigger ferroptosis in NP cells while inhibiting TNFα-mediated apoptosis. Further experiments demonstrated that FSP1 was closely related to TNFα-reliant caspase 3 activation and mitochondrial damage. However, the exogenous addition of recombinant protein FSP1 does not induce cell death or intensify the efficacy of TNFα. Mechanically, FSP1 is involved in TNFα-mediated NF-κB signaling activation to accelerate the development of IDD. This study demonstrated that FSP1 promotes IDD through TNFα-reliant NF-κB signaling activation and caspase 3-dependent apoptosis. These findings suggested a novel therapeutic target for the treatment of IDD.

To review the clinical efficacy of minimally invasive pedicle fixation combined with anterior small incision focus debridement for single-segment lumbar spine tuberculosis, a total of 31 patients with single-segment marginal lumbar tuberculosis were enrolled in the study. All the patients received quadruple anti-tuberculosis chemotherapy for 2 weeks before surgery and treatment with minimally invasive posterior internal fixation, anterior small incision focus debridement, and bone graft fusion. Those patients with preoperative kyphosis deformity were initially treated with appropriate posterior distraction correction. Except for 1 patient who healed 2 weeks after medical dressing change, the remaining 30 patients healed as expected. All the patients had no screw- related surgical complications, neurological dysfunction, vascular injury, and other complications. The average visual analog scale scores at 3 months postoperatively were significantly decreased to 1.4 ± 1.5 (P < 0.05). In conclusion, under the premise of treatment using appropriate, effective anti-tuberculosis agents, this surgical procedure for managing patients with lumbar vertebral tuberculosis achieved satisfactory results, effectively reducing the exposure range and fusion segments in simple anterior focus debridement and internal fixation. Using minimally invasive posterior pedicle screw fixation can effectively increase spine stability, reduce fusion segment, and decrease anterior surgical trauma and complications.