Department of Neurosurgery, Siirt University, Turkey.
Department of Neurosurgery, Siirt Training and Research Hospital, Turkey.
Adv Clin Exp Med. 2022 Sep;31(9):947-952. doi: 10.17219/acem/149336.
The inflammatory index can be useful for neurosurgeons to understand and grade pain in degenerated intervertebral disc (DIVD).
The study focused on the value of the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and the inflammatory multiple indices (MIs), and aimed to compare its efficiency with the preoperative and postoperative pain scale and scoring algorithms.
A total of 88 DIVD patients were included in this retrospective clinical cohort study. Visual Analogue Scale Back (VASB) and Visual Analogue Scale Leg (VASL), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and walking distance (WD) were used to assess pain. The multiple index (MI) was calculated as MI-1 = PLR × C-reactive protein (CRP) and MI-2 = NLR × CRP.
Comparing the MI with ODI, no correlation was found in preoperative values, while a positive correlation (MI-1: r = 0.398, p < 0.001; MI-2: r = 0.285; p = 0.007) was found between the postoperative measurements. A significant correlation was found for VASB and both MI-1 (preoperative: r = 0.373, p = 0.001; postoperative: r = 0.232, p = 0.041) and MI-2 (preoperative: r = 0.388, p < 0.001; postoperative: r = 0.206, p = 0.044). The MI-1 index showed 71.4% sensitivity and 73.3% specificity, while the MI-2 index exhibited 78.6% sensitivity and 68.9% specificity.
MI-1 and MI-2 showed a positive correlation with preand post-operative VASB score and had strong potential to predict postoperative pain in DIVD. They are easy-to-use, noninvasive and low-cost indices; therefore, our results are promising for routine application.
炎症指数可帮助神经外科医生了解和评估退行性椎间盘病变（DIVD）的疼痛程度。
本研究旨在探讨血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）和炎症多项指标（MI）的价值，并将其与术前和术后疼痛评分及评分算法进行比较。
回顾性临床队列研究共纳入 88 例 DIVD 患者。采用视觉模拟评分法背部（VASB）和腿部（VASL）、Oswestry 功能障碍指数（ODI）、Roland-Morris 残疾问卷（RMDQ）和行走距离（WD）评估疼痛。计算多项指标（MI），MI-1=PLR×C 反应蛋白（CRP），MI-2=NLR×CRP。
MI 与 ODI 术前值无相关性，而术后值呈正相关（MI-1：r=0.398，p<0.001；MI-2：r=0.285；p=0.007）。VASB 与 MI-1（术前：r=0.373，p=0.001；术后：r=0.232，p=0.041）和 MI-2（术前：r=0.388，p<0.001；术后：r=0.206，p=0.044）均呈显著相关。MI-1 指数的敏感性为 71.4%，特异性为 73.3%；MI-2 指数的敏感性为 78.6%，特异性为 68.9%。
MI-1 和 MI-2 与术前和术后 VASB 评分呈正相关，具有预测 DIVD 术后疼痛的强大潜力。这些指标使用方便、无创且成本低廉，因此有望在常规应用中得到推广。
