Ethemoğlu Kadri Burak, Erkoç Yavuz Selim
Neurosurgery, Harran University, Şanlıurfa, TUR.
Neurosurgery, Kecioren Education and Research Hospital, Ankara, TUR.
Cureus. 2020 Aug 31;12(8):e10161. doi: 10.7759/cureus.10161.
Objective Inflammation plays an important role in the pathophysiology of disc herniation. The aim of this study was to evaluate blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-reactive protein (CRP) levels in cervical disc herniation (CDH) patients. Materials and methods We retrospectively analyzed the medical records of 126 patients with neck pain who were treated as inpatients at the Neurosurgery Department of Harran University Faculty of Medicine. The NLR, PLR, and CRP levels during hospital admissions were documented. Results The study included 73 patients with CDH and neck pain, 53 patients with normal cervical MR examination and neck pain, and 50 healthy control subjects. The group with cervical disc hernia had a significantly higher mean serum leucocyte count, neutrophil count, NLR, and CRP level compared to those with a normal MR but neck pain and the control group. NLR was significantly higher in the multi-level CDH group compared to the control group, while the single-level CDH and multi-level CDH had no significant difference with respect to mean serum inflammatory parameters. Conclusion Higher NLR and CRP in patients with CDH compared to patients with neck pain but normal cervical MR and the controls may be due to a developing inflammatory response. It may be speculated that among patients with neck pain, those with non-elevated NLR and CRP levels may have normal neck MR imaging, and in patients with elevated NLR and CRP levels, early protective approaches may play a preventive role in disc degeneration and cervical disc hernia development.
目的 炎症在椎间盘突出症的病理生理学中起重要作用。本研究旨在评估颈椎间盘突出症(CDH)患者的血液中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及C反应蛋白(CRP)水平。
材料与方法 我们回顾性分析了哈兰大学医学院神经外科收治的126例颈部疼痛住院患者的病历。记录住院期间的NLR、PLR和CRP水平。
结果 该研究纳入了73例患有CDH和颈部疼痛的患者、53例颈椎磁共振检查正常但有颈部疼痛的患者以及50名健康对照者。与颈椎磁共振正常但有颈部疼痛的患者及对照组相比,颈椎间盘疝组的平均血清白细胞计数、中性粒细胞计数、NLR和CRP水平显著更高。与对照组相比,多节段CDH组的NLR显著更高,而单节段CDH组和多节段CDH组在平均血清炎症参数方面无显著差异。
结论 与颈部疼痛但颈椎磁共振正常的患者及对照组相比,CDH患者的NLR和CRP更高可能是由于炎症反应的发展。可以推测,在颈部疼痛的患者中,NLR和CRP水平未升高的患者颈椎磁共振成像可能正常,而在NLR和CRP水平升高的患者中,早期保护措施可能对椎间盘退变和颈椎间盘疝的发展起到预防作用。