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Diagnostic Efficiency of Inflammatory Prognostic Index on Pain Scoring for Degenerated Intervertebral Disc

Yıl 2022, Cilt: 4 Sayı: 3, 340 - 344, 22.09.2022
https://doi.org/10.37990/medr.1098908

Öz

Aim: Inflammatory Prognostic Index (IPI), calculated via Albumin, CRP and Neutrophil-Lymphocyte Ratio (NLR), is used in the inflammation related diseases. The study focused the efficacy and predictive effect of the IPI in terms of Visual Analog Scales (VAS) for interpretation of back and leg pain.
Materials and Methods: This multicenter retrospective clinical study was performed by the hospital records of the Degenerated Intervertebral Disc (DIVD) treated between January 2020 and February 2022. IPI value was calculated by the formula of “CRPxNLR/Albumin”.
Results: There was a significant difference between VAS-B (2.38±1.74; p=0.0001) and VAS-L (7.09±1.44; p=0.00017) in the comparison of paired VAS values before and after the surgery. Similar change occurred within walking distance after surgery. According to the correlation analysis of the IPI index with DIVD pain scoring, VAS-B(r=0.391; p=0.00017) and delta VAS-B (r=0.422; p=0,00004) showed a positive correlation with the IPI. In the ROC analysis for the diagnostic value of the IPI, the cut-off value of VAS-L above 0.184 showed a diagnostic value as 78.9% sensitivity and 64.3% specificity (UAC:0.702; p:0.003; CI%95: 0.581-0.815).
Conclusion: We showed a strong relationship between IPI and pain scoring of DIVD. The diagnostic value of IPI with VAS-L was very important and can be used by physicians for pain follow-up of DIVD.

Kaynakça

  • 1. Motta E, Boniotti V, Miserocchi L, Caudana R. Usefulness of gadolinium in MRI evaluation of non surgically treated herniated disk. La Radiologia medica. 2005;109(5-6):547-54.
  • 2. Lee JH, Lee SH. Clinical effectiveness of percutaneous adhesiolysis using Navicath for the management of chronic pain due to lumbosacral disc herniation. Pain physician. 2012;15(3): 213-21.
  • 3. Hadžić E, Splavski B, Lakičević G. Comparison of early and delayed lumbar disc herniation surgery and the treatment outcome. Medicinski glasnik: official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina. 2021;18(2):456-62.
  • 4. Ahsan K, Khan SI, Zaman N, Ahmed N, Montemurro N, Chaurasia B. Fusion versus nonfusion treatment for recurrent lumbar disc herniation. Journal of craniovertebral junction & spine. 2021;12(1):44-53.
  • 5. Abdullah F, Bai A, Sahil F, Kataria D, Abbas M, Ullah F, et al. Lumbar Disc Herniation: Comparing Pain Relief After Medical and Surgical Intervention. Cureus. 2021;13(6):e15885.
  • 6. Tascioglu T, Sahin O. The relationship between pain and herniation radiology in giant lumbar disc herniation causing severe sciatica: 15 cases. British journal of neurosurgery. 2020:1-4.
  • 7. Zhao X, Zhu CZ, Yang H, Guo W. [Application of pain pressure threshold test in lumbar intervertebral disc herniation study]. Zhongguo gu shang = China journal of orthopaedics and traumatology. 2020;33(5):435-9.
  • 8. Wang Y, Teng HL, Zhu MY, Huang KL, Lin CW. [Clinical outcomes of spinal endoscopic surgery for tiny lumbar disc herniation with severe radiating pain of lower limb]. Zhongguo gu shang = China journal of orthopaedics and traumatology. 2020;33(6):508-13.
  • 9. Bilgin E, Ökten A. Post-operative pain management for single-level lumbar disc herniation surgery: A comparison of betamethasone, ibuprofen, and pregabalin. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology. 2021;33(2):89-95.
  • 10. Zhou F, Tao H, Liu G, Zhang Y, Zhang Y, Zhou K. Clinical effect of TESSYS technique under spinal endoscopy combined with drug therapy in patients with lumbar disc herniation and its effect on quality of life and serum inflammatory factors: results of a randomized trial. Annals of palliative medicine. 2021;10(8):8728-36.
  • 11. Bai X, Lian Y, Wang J, Zhang H, Jiang M, Zhang H, et al. Percutaneous endoscopic lumbar discectomy compared with other surgeries for lumbar disc herniation: A meta-analysis. Medicine. 2021;100(9):e24747.
  • 12. Arirachakaran A, Siripaiboonkij M, Pairuchvej S, Setrkraising K, Pruttikul P, Piyasakulkaew C, et al. Comparative outcomes of epidural steroids versus placebo after lumbar discectomy in lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie. 2018;28(8):1589-99.
  • 13. Shi R, Wang F, Hong X, Wang YT, Bao JP, Liu L, et al. Comparison of percutaneous endoscopic lumbar discectomy versus microendoscopic discectomy for the treatment of lumbar disc herniation: a meta-analysis. International orthopaedics. 2019;43(4):923-37.
  • 14. Xu Z, Wu S, Li X, Liu C, Fan S, Ma C. Ultrasound-Guided Transforaminal Injections of Platelet-Rich Plasma Compared with Steroid in Lumbar Disc Herniation: A Prospective, Randomized, Controlled Study. Neural plasticity. 2021;2021:5558138.
  • 15. Rawson B. Platelet-Rich Plasma and Epidural Platelet Lysate: Novel Treatment for Lumbar Disk Herniation. The Journal of the American Osteopathic Association. 2020;120(3):201-7.
  • 16. Furusawa N, Baba H, Miyoshi N, Maezawa Y, Uchida K, Kokubo Y, et al. Herniation of cervical intervertebral disc: immunohistochemical examination and measurement of nitric oxide production. Spine. 2001;26(10):1110-6.
  • 17. Kerezoudis P, Goncalves S, Cesare JD, Alvi MA, Kurian DP, Sebastian AS, et al. Comparing outcomes of fusion versus repeat discectomy for recurrent lumbar disc herniation: A systematic review and meta-analysis. Clinical neurology and neurosurgery. 2018;171:70-8.
  • 18. Gopireddy R, Rangasamy K, Goni VG, Vatsya P, Behera P, Batra YK, et al. Can High-Sensitivity C-Reactive Protein Levels Predict Functional Outcome Following Epidural Steroid Injection in Patients with Lumbar Disc Disease? Asian spine journal. 2021;15(6):753-60.
  • 19. Ackerman WE, 3rd, Zhang JM. Serum hs-CRP as a useful marker for predicting the efficacy of lumbar epidural steroid injections on pain relief in patients with lumbar disc herniations. The Journal of the Kentucky Medical Association. 2006;104(7):295-9.
  • 20. Le Gars L, Borderie D, Kaplan G, Berenbaum F. Systemic inflammatory response with plasma C-reactive protein elevation in disk-related lumbosciatic syndrome. Joint bone spine. 2000;67(5):452-5.
  • 21. Deguchi M, Shinjo R, Yoshioka Y, Seki H. The usefulness of serum amyloid A as a postoperative inflammatory marker after posterior lumbar interbody fusion. The Journal of bone and joint surgery British volume. 2010;92(4):555-9.
  • 22. Bozkurt H, Arac D, Cigdem B. Effect of Preoperative Uric Acid Level and Neutrophil / Lymphocyte Ratio on Preoperative and Postoperative Visual Analogue Pain Scores in Patients with Lumbar Disc Herniation: A Cross-Sectional Study. Turkish neurosurgery. 2019;29(5): 705-9.
  • 23. Ethemoğlu KB, Erkoç YS. Is There Any Relationship Between Cervical Disc Herniation and Blood Inflammatory Response? Cureus. 2020;12(8):e10161.

Dejenere Intervertebral Disk için Ağrı Skorlamasında İnflamatuar Prognostik İndeksin Tanısal Etkinliği

Yıl 2022, Cilt: 4 Sayı: 3, 340 - 344, 22.09.2022
https://doi.org/10.37990/medr.1098908

Öz

Amaç: Albümin, CRP ve Nötrofil-Lenfosit Oranı (NLR) ile hesaplanan İnflamatuvar Prognostik İndeks (IPI), inflamasyona bağlı hastalıklarda kullanılmaktadır. Çalışmamız, sırt ve bacak ağrısının yorumlanması için Görsel Analog Ölçekler (VAS) açısından IPI’nin etkinliğine ve öngörücü etkisine odaklandı.
Materyal ve Metot: Bu çok merkezli retrospektif klinik çalışma, Ocak 2020 ile Şubat 2022 arasında tedavi edilen Dejenere Intervertebral Disk (DIVD) hastalarının hastane kayıtları üzerinden yürütülmüştür. IPI değeri “CRPxNLR/Albumin” formülü ile hesaplanmıştır.
Bulgular: Ameliyat öncesi ve sonrası ikili VAS değerleri karşılaştırıldığında, VAS-B (2.38±1.74; p=0.0001) ve VAS-L (7.09±1.44; p=0.00017) arasında anlamlı fark tespit edildi. Ameliyattan sonra yürüme mesafesinde de benzer bir değişiklik meydana geldi. IPI indeksinin DIVD ağrı skorlaması ile korelasyon analizine göre, VAS-B (r=0,391; p=0,00017) ve delta VAS-B (r=0,422; p=0,00004) ile IPI değeri pozitif korelasyon gösterdi. IPI’nin tanısal değeri için yapılan ROC analizinde, VAS-L’nin 0,184’ün üzerindeki kesim değeri, %78,9 duyarlılık ve %64,3 özgüllük olarak tanısal değer göstermiştir (UAC:0.702; s:0,003; CI %95: 0.581-0.815).
Sonuç: IPI ile DIVD’nin ağrı skorlaması arasında güçlü bir ilişki olduğunu gösterdik. VAS-L ile IPI’nin tanı değeri çok önemliydi ve doktorlar tarafından DIVD’nin ağrı takibinde kullanılabileceğini düşünmekteyiz.

Kaynakça

  • 1. Motta E, Boniotti V, Miserocchi L, Caudana R. Usefulness of gadolinium in MRI evaluation of non surgically treated herniated disk. La Radiologia medica. 2005;109(5-6):547-54.
  • 2. Lee JH, Lee SH. Clinical effectiveness of percutaneous adhesiolysis using Navicath for the management of chronic pain due to lumbosacral disc herniation. Pain physician. 2012;15(3): 213-21.
  • 3. Hadžić E, Splavski B, Lakičević G. Comparison of early and delayed lumbar disc herniation surgery and the treatment outcome. Medicinski glasnik: official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina. 2021;18(2):456-62.
  • 4. Ahsan K, Khan SI, Zaman N, Ahmed N, Montemurro N, Chaurasia B. Fusion versus nonfusion treatment for recurrent lumbar disc herniation. Journal of craniovertebral junction & spine. 2021;12(1):44-53.
  • 5. Abdullah F, Bai A, Sahil F, Kataria D, Abbas M, Ullah F, et al. Lumbar Disc Herniation: Comparing Pain Relief After Medical and Surgical Intervention. Cureus. 2021;13(6):e15885.
  • 6. Tascioglu T, Sahin O. The relationship between pain and herniation radiology in giant lumbar disc herniation causing severe sciatica: 15 cases. British journal of neurosurgery. 2020:1-4.
  • 7. Zhao X, Zhu CZ, Yang H, Guo W. [Application of pain pressure threshold test in lumbar intervertebral disc herniation study]. Zhongguo gu shang = China journal of orthopaedics and traumatology. 2020;33(5):435-9.
  • 8. Wang Y, Teng HL, Zhu MY, Huang KL, Lin CW. [Clinical outcomes of spinal endoscopic surgery for tiny lumbar disc herniation with severe radiating pain of lower limb]. Zhongguo gu shang = China journal of orthopaedics and traumatology. 2020;33(6):508-13.
  • 9. Bilgin E, Ökten A. Post-operative pain management for single-level lumbar disc herniation surgery: A comparison of betamethasone, ibuprofen, and pregabalin. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology. 2021;33(2):89-95.
  • 10. Zhou F, Tao H, Liu G, Zhang Y, Zhang Y, Zhou K. Clinical effect of TESSYS technique under spinal endoscopy combined with drug therapy in patients with lumbar disc herniation and its effect on quality of life and serum inflammatory factors: results of a randomized trial. Annals of palliative medicine. 2021;10(8):8728-36.
  • 11. Bai X, Lian Y, Wang J, Zhang H, Jiang M, Zhang H, et al. Percutaneous endoscopic lumbar discectomy compared with other surgeries for lumbar disc herniation: A meta-analysis. Medicine. 2021;100(9):e24747.
  • 12. Arirachakaran A, Siripaiboonkij M, Pairuchvej S, Setrkraising K, Pruttikul P, Piyasakulkaew C, et al. Comparative outcomes of epidural steroids versus placebo after lumbar discectomy in lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie. 2018;28(8):1589-99.
  • 13. Shi R, Wang F, Hong X, Wang YT, Bao JP, Liu L, et al. Comparison of percutaneous endoscopic lumbar discectomy versus microendoscopic discectomy for the treatment of lumbar disc herniation: a meta-analysis. International orthopaedics. 2019;43(4):923-37.
  • 14. Xu Z, Wu S, Li X, Liu C, Fan S, Ma C. Ultrasound-Guided Transforaminal Injections of Platelet-Rich Plasma Compared with Steroid in Lumbar Disc Herniation: A Prospective, Randomized, Controlled Study. Neural plasticity. 2021;2021:5558138.
  • 15. Rawson B. Platelet-Rich Plasma and Epidural Platelet Lysate: Novel Treatment for Lumbar Disk Herniation. The Journal of the American Osteopathic Association. 2020;120(3):201-7.
  • 16. Furusawa N, Baba H, Miyoshi N, Maezawa Y, Uchida K, Kokubo Y, et al. Herniation of cervical intervertebral disc: immunohistochemical examination and measurement of nitric oxide production. Spine. 2001;26(10):1110-6.
  • 17. Kerezoudis P, Goncalves S, Cesare JD, Alvi MA, Kurian DP, Sebastian AS, et al. Comparing outcomes of fusion versus repeat discectomy for recurrent lumbar disc herniation: A systematic review and meta-analysis. Clinical neurology and neurosurgery. 2018;171:70-8.
  • 18. Gopireddy R, Rangasamy K, Goni VG, Vatsya P, Behera P, Batra YK, et al. Can High-Sensitivity C-Reactive Protein Levels Predict Functional Outcome Following Epidural Steroid Injection in Patients with Lumbar Disc Disease? Asian spine journal. 2021;15(6):753-60.
  • 19. Ackerman WE, 3rd, Zhang JM. Serum hs-CRP as a useful marker for predicting the efficacy of lumbar epidural steroid injections on pain relief in patients with lumbar disc herniations. The Journal of the Kentucky Medical Association. 2006;104(7):295-9.
  • 20. Le Gars L, Borderie D, Kaplan G, Berenbaum F. Systemic inflammatory response with plasma C-reactive protein elevation in disk-related lumbosciatic syndrome. Joint bone spine. 2000;67(5):452-5.
  • 21. Deguchi M, Shinjo R, Yoshioka Y, Seki H. The usefulness of serum amyloid A as a postoperative inflammatory marker after posterior lumbar interbody fusion. The Journal of bone and joint surgery British volume. 2010;92(4):555-9.
  • 22. Bozkurt H, Arac D, Cigdem B. Effect of Preoperative Uric Acid Level and Neutrophil / Lymphocyte Ratio on Preoperative and Postoperative Visual Analogue Pain Scores in Patients with Lumbar Disc Herniation: A Cross-Sectional Study. Turkish neurosurgery. 2019;29(5): 705-9.
  • 23. Ethemoğlu KB, Erkoç YS. Is There Any Relationship Between Cervical Disc Herniation and Blood Inflammatory Response? Cureus. 2020;12(8):e10161.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Özgün Makaleler
Yazarlar

Mustafa Nevzat Firidin 0000-0002-0927-8848

Mehmet Emin Akyüz 0000-0003-0626-3509

Yayımlanma Tarihi 22 Eylül 2022
Kabul Tarihi 22 Haziran 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 4 Sayı: 3

Kaynak Göster

AMA Firidin MN, Akyüz ME. Diagnostic Efficiency of Inflammatory Prognostic Index on Pain Scoring for Degenerated Intervertebral Disc. Med Records. Eylül 2022;4(3):340-344. doi:10.37990/medr.1098908

 Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey

E-mail: medrecsjournal@gmail.com

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