Tek Seviye Lomber Disk Hernisi Ve Çok Seviyeli Lomber Spinal Stenoz Hastalarında Sistemik İnflamasyon Varlığının Araştırılması

Year 2019, , 247 - 252, 28.06.2019

Ömer Polat , Cengiz Tuncer

https://doi.org/10.18521/ktd.566585

Abstract

Amaç: Disk hernisi ve spinal stenoz varlığında
semptomların gelişebilmesi için sinir kökünde inflamasyon ve irritasyonun olması
gerektiği belirtilmektedir. Bu çalışmada inflamatuar
değişikliklerin hastalık patogenezinde yer aldığı belirtilen tek seviye lomber disk hernisi ve çok seviyeli
lomber spinal stenoz hastalarında sistemik inflamasyonun belirteçleri olarak
kabul edilen nötrofil lenfosit oranı ve trombosit lenfosit oranını kullanarak bu iki
hastalık arasındaki inflamatuar farklılığı ortaya koymak amaçlandı.

Gereç ve Yöntem: Tek seviye lomber disk hernisi tanısı almış 50
hasta (31 kadın, 19 erkek), lomber spinal stenoz tanısı almış 50 hasta (34
kadın, 16 erkek) ve 50 sağlıklı birey (33 kadın, 17 erkek) oluşan kontrol grubu
olarak
çalışmaya dahil edildi. Üç
grubun tam kan değerleri retrospektif olarak hastane verilerinden kaydedildi.

Bulgular: Gruplar arasında nötrofil lenfosit oranı ve
trombosit lenfosit oranını değerleri açısından istatistiksel olarak anlamlı bir
farklılık vardı (sırasıyla, p<0.001, p=0.003). Kontrol grubunun değerleri
diğer gruplara göre daha düşük olarak saptandı. Ayrıca lomber spinal stenoz
grubunda nötrofil lenfosit oranı değerlerinin daha yüksek olduğu ve lomber disk
hernisi grubu ile de istatistiksel olarak anlamlı bir fark olduğu tespit edildi
(p<0.001).

Sonuç: Nötrofil lenfosit oranı ve trombosit lenfosit
oranını değerleri sinir dokusunda ortaya çıkan
inflamasyonu değerlendirmekte kolay uygulanabilen ve düşük maliyetli tam kan sayımı
verilerinden hesaplanarak elde edilen yeni belirteçlerdir. Kompresyona uğrayan sinir dokusunun artıp
artmadığını anlamakta nötrofil lenfosit oranı hekime
kolaylık sağlayabilir.

Keywords

Tek Seviye Lomber Disk Hernisi, Çok Seviyeli Lomber Spinal Stenoz, İnflamasyon, Nötrofil, Lenfosit

Supporting Institution

Yok

Investigation of Systemic Inflammation in Single Level Lumbar Disc Herniation and Multilevel Lumbar Spinal Stenosis Patients

Abstract

Objective:
It
is stated that there must be inflammation and irritation in the nerve root in
order to develop symptoms in the presence of disc herniation and spinal
stenosis. In this study, it was aimed to reveal the inflammatory difference
between these two diseases by using neutrophil lymphocyte ratio and platelet
lymphocyte ratio which are accepted as markers of systemic inflammation in
single level lumbar disc herniation and multi-level lumbar spinal stenosis
patients.

Methods:
Fifty
patients (31 female, 19 male) with a single lumbar disc herniation, 50 patients
(34 female, 16 male) with lumbar spinal stenosis and 50 healthy controls (33
female, 17 male) was included in the study.The complete blood count of the
three groups were recorded retrospectively from the hospital data.

Results:
There
was a statistically significant difference between the groups in terms of
neutrophil lymphocyte ratio and platelet lymphocyte ratio (p <0.001, p =
0.003, respectively). The values of the control group were lower than the other
groups. In addition, it was detected that the lumbar spinal stenosis group had
higher neutrophil lymphocyte ratio and there was a statistically significant
difference with lumbar disc herniation group (p <0.001).

Conclusion:
Neutrophil
lymphocyte ratio and platelet lymphocyte ratio are the new markers that can be
easily applied to evaluate inflammation in nerve tissue and calculated from
low-cost complete blood count data. The neutrophil lymphocyte ratio may be
easier for the physician to understand whether the compressed nerve tissue
increases.

Keywords

Single Level Lumbar Disc Herniation, Multilevel Lumbar Spinal Stenosis, Inflammation, Neutrophil

References

• 1. Polat Ö, Uçkun A. Lomber Disk Hastalığında Konservatif Tedavi Yöntemleri. Türk Nöroşir Derg 2018;28:185-189.
• 2. Dönmez YC, Dolgun E, Kabataş M, Özbayır T. Lomber Disk Hernili Hastalarda Risk Faktörlerinin İncelenmesi. F.Ü.Sağ.Bil.Tıp Derg. 2010:24:89-92.
• 3. Şendur F. Lomber Spinal Stenoz. Turkiye Klinikleri J PM&R-Special Topics 2011;4:44-52.
• 4. Hansson T, Suzuki N, Hebelka H, Gaulitz A. The narrowing of the lumbar spinal canal during loading MRI: The effects of the disc and ligamentum flavum. Eur Spine J 2009;18:679-86. 5. Seçen AE, Yiğitkanlı K. Lomber Dar Kanal; Patofizyoloji ve Doğal Seyir. Türk Nöroşir Derg 2018;28:216-20.
• 6. Leithead J. A, Rajoriya N, Gunson BK, Ferguson JW. Neutrophil-to-lymphocyte ratio predicts mortality in patients listed for liver transplantation. Liver Int 2015;35:502-9.
• 7. Huang W, Huang J, Liu Q, Lin F, He Z, Zeng Z, He L. Neutrophil-lymphocyte ratio is a reliable predictive marker for early-stage diabetic nephropathy. Clin Endocrinol 2014;82:229-33.
• 8. Ozer S, Yılmaz R, Sonmezgoz E, Karaaslan E, Taskin S, Burun I, Demir O. Simple markers for subclinical inflammation in patients with mediterranene fever. Med Sci Monit 2015;21:298-303.
• 9. Fu H, Qin B, Hu Z, et al. Neutrophil-and platelet-to-lympohcyte ratio are correlated with disease activity in rheumatoid arthritis. Clin Lab 2015;61:269-73.
• 10. Han LH, Jia YB, Song QX, Wang JB, Wang NN, Cheng YF. Prognostic significance of preoperative lymphocyte-monocyte ratio in patients with resectable esophageal squamous cell carcinoma. Asian Pac J cancer Prev 2015;16:2245-50.
• 11. Zahorec R. Ratio of neutrophil to lymphocyte counts—Rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102:5-14. 12. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophillymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181-4.
• 13. Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, et al. Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer. Dis Markers 2019;2019:6036979.
• 14. Luo H, He L, Zhang G, et al. Normal Reference Intervals of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, Lymphocyte-To-Monocyte Ratio, and Systemic Immune Inflammation Index in Healthy Adults: a Large Multi-Center Study from Western China. Clin Lab. 2019;65(3). doi: 10.7754/Clin.Lab.2018.180715.
• 15. Paramanathan A, Saxena A, Morris DL. A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte raito on long term outcomes after curative intent resection of solid tumors. Surgical Oncology 2014;23:31-9.
• 16. Leithead JA, Rajoriya N, Gunson BK, Ferguson W. Neutrophil-to-lymphocyte ratio predicts mortality in patients listed for liver transplantation. Liver International 2015;35:502-9.
• 17. Fan W, Zhang Y, Wang Y, Yao X, Yang J, Li J. Neutrophil-to-lymhocyte and platelet-to-lymhocyte ratios as predictors of survival and metastasis for recurrent hepatocellular carcinoma after transarterial chemoembolization. PLoS One 2015;10:e0119312.
• 18. Celik A, Ozcan IT, Gundes A, et al. Usefulness of admission hematology parameters as diagnostic tools in acute pulmonary embolism. Kaohsiung J Med Sci 2015;31:145-9. 19. Aydoğdu İ, Yıldırım G, Kumral TL, Saltürk Z, Aydoğdu Z, İnan M, Uyar Y. Ani İşitme Kaybı Olan Hastalarda Yeni Prognostik Parametreler: Nötrofil/Lenfosit Oranı ve Platelet/Lenfosit Oranı. Okmeydanı Tıp Dergisi 2017;33:1-5.
• 20. Kim EY, Lee JW, Yoo HM, Park CH, Song KY. The platelet-to-lymphocyte ratio versus neutrophil-to-leymphocyte ratio: which is better as a prognostic factor in gastric cancer? Ann Surg Oncol 2015;22:4363-70.
• 21. Yildirim M, Turkyilmaz E, Avsar AF. Preoperative neutrophil-to-leymphocyte ratio has a better predictive capacity in diagnosing tuba-ovarian abscess. Gynecol Obstet Invest 2015;80:234-9.
• 22. Oya R, Takenaka Y, Imai T, Sato T, Oshima K, Ohta Y, Inohara H. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Hematologic Markers of Bell's Palsy: A Meta-analysis. Otol Neurotol 2019 Feb 15. doi: 10.1097/MAO.0000000000002166. 23. Dagistan Y, Dagistan E, Gezici AR, Halicioglu S, Akar S, Özkan N, Gulali A. Could red cell distribution width and mean platelet volume be a predictor for lumbar disc hernias? Ideggyogy Sz 2016;69:411-4.