Preoperative and postoperative diagnostic efficiency of multi-inflammatory index on pain scoring of degenerated intervertebral disc

Abstract

Background. The inflammatory index can be useful for neurosurgeons to understand and grade pain in degenerated intervertebral disc (DIVD). Objectives. The study focused on the value of the platelet-to-lymphocyte ratio (PLR), neutrophil-tolymphocyte ratio (NLR) and the inflammatory multiple indices (MIs), and aimed to compare its efficiency with the preoperative and postoperative pain scale and scoring algorithms. Materials and methods. 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 x C-reactive protein (CRP) and MI-2 = NLR x CRP. Results. 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. Conclusions. MI-1 and MI-2 showed a positive correlation with pre- and 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.