Evaluation of the Naples Score in Patients Undergoing Lumbar Disc Herniation Surgery: Its Role and Association with Impact on Postoperative Clinical Recovery

Öz

Objective: This study aimed to evaluate the usability of the Naples Score as a systemic indicator of inflammation in patients with lumbar disc herniation and to investigate its possible association with surgical outcomes. Materials and Methods: This single-center, prospective study included 73 patients who underwent microsurgical discectomy. Preoperative blood samples were analyzed for total cholesterol, serum albumin, neutrophil-to-lymphocyte ratio and lymphocyte-to-monocyte ratio. Based on these parameters, patients were divided into three groups according to the Naples Score classification. Visual Analog Scale and Oswestry Disability Index scores were compared for all participants before surgery and at 45 days postoperatively. Results: The mean age of the participants was 50.5 ± 13.5 years, and 63% were female. The distribution of Naples Score groups was as follows: Group 1 (32.9%), Group 2 (34.2%), and Group 3 (32.9%). The mean preoperative Visual Analog Scale score decreased from 9.48 ± 0.75 to 2.04 ± 1.66 postoperatively. Similarly, the Oswestry Disability Index score declined from 81.19 ± 14.55 preoperatively to 17.28 ± 13.81 postoperatively. However, no statistically significant differences were found between the Naples Score groups in terms of changes in Visual Analog Scale and Oswestry Disability Index values (p > 0.05). Conclusion: The Naples Score may be a useful parameter for assessing systemic inflammation in patients with lumbar disc herniation. However, no significant association was found between preoperative Naples Score levels and postoperative improvement. These findings indicate that local and systemic inflammatory responses may differ biologically, warranting further multicenter studies with larger samples.

Anahtar Kelimeler

• Inflammation
• Lumbar Disc Herniation
• Microsurgical Discectomy

Etik Beyan

Ethical Approval: The study was conducted with the approval of the Ordu University Ethics Committee (Decision No: 2025/12-BAEK-06, Date: January 3, 2025).

Lomber Disk Hernisi Cerrahisi Geçiren Hastalarda Naples Skorunun Değerlendirilmesi: Postoperatif Klinik İyileşme Üzerindeki Etkisi ve İlişkisi

Öz

Amaç: Bu çalışmada, lomber disk hernili hastalarda inflamasyonun sistemik bir göstergesi olarak Naples Skoru’nun kullanılabilirliği ve cerrahi sonuçlarla olası ilişkisi değerlendirildi. Gereç ve Yöntem: Tek merkezli, prospektif olarak planlanan bu çalışmaya mikrocerrahi diskektomi uygulanan 73 hasta dâhil edildi. Preoperatif dönemde hastalardan alınan kan örneklerinde total kolesterol, serum albümin, nötrofil/lenfosit oranı ve lenfosit/monosit oranı değerlendirildi. Bu parametrelere göre hastalar Naples Skor sınıflamasına göre üç gruba ayrıldı. Tüm katılımcılarda cerrahi öncesi ve cerrahiden 45 gün sonraki dönemde Vizüel Analog Skala ve Oswestry Özürlülük İndeksi skorları karşılaştırıldı. Bulgular: Katılımcıların yaş ortalaması 50,5±13,5 yıl olup, %63’ü kadındı. Naples Skor dağılımı Grup 1 (%32,9), Grup 2 (%34,2) ve Grup 3 (%32,9) olarak bulundu. Preoperatif dönemde ortalama Vizüel Analog Skala skoru 9,48±0,75 iken postoperatif dönemde 2,04±1,66’ya geriledi. Oswestry Özürlülük İndeksi skoru ise preoperatif dönemde 81,19±14,55’ten postoperatif dönemde 17,28±13,81’e düştü. Ancak Naples Skor grupları arasında Vizüel Analog Skala ve Oswestry Özürlülük İndeksi değerlerindeki değişim açısından istatistiksel olarak anlamlı fark saptanmadı (p>0,05). Sonuç: Naples Skoru, lomber disk hernisi olan hastalarda sistemik inflamasyonun değerlendirilmesinde faydalı bir parametre olabilir. Ancak, ameliyat öncesi Naples Skoru seviyeleri ile ameliyat sonrası iyileşme arasında anlamlı bir ilişki bulunamamıştır. Bu bulgular, lokal ve sistemik inflamasyon yanıtlarının biyolojik olarak farklılık gösterebileceğini ve daha geniş örneklem gruplarıyla çok merkezli çalışmalar yapılmasını gerektirmektedir.

Anahtar Kelimeler

• İnflamasyon
• Lomber disk hernisi
• Mikrocerrahi diskektomi

Etik Beyan

Etik Onay: Çalışma, Ordu Üniversitesi Etik Kurulu’nun onayı ile yürütülmüştür (Karar No: 2025/12-BAEK-06, Tarih: 3 Ocak 2025).

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