Is There Any Relationship Between Cervical Disc Herniation and Blood Inflammatory Response?

Kadri Burak Ethemoğlu,Yavuz Selim Erkoç

doi:10.7759/cureus.10161

Abstract

ObjectiveInflammation plays an important role in the pathophysiology of disc herniation. The aim of this study was to evaluate blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-reactive protein (CRP) levels in cervical disc herniation (CDH) patients.Materials and methodsWe retrospectively analyzed the medical records of 126 patients with neck pain who were treated as inpatients at the Neurosurgery Department of Harran University Faculty of Medicine. The NLR, PLR, and CRP levels during hospital admissions were documented.ResultsThe study included 73 patients with CDH and neck pain, 53 patients with normal cervical MR examination and neck pain, and 50 healthy control subjects. The group with cervical disc hernia had a significantly higher mean serum leucocyte count, neutrophil count, NLR, and CRP level compared to those with a normal MR but neck pain and the control group. NLR was significantly higher in the multi-level CDH group compared to the control group, while the single-level CDH and multi-level CDH had no significant difference with respect to mean serum inflammatory parameters.ConclusionHigher NLR and CRP in patients with CDH compared to patients with neck pain but normal cervical MR and the controls may be due to a developing inflammatory response. It may be speculated that among patients with neck pain, those with non-elevated NLR and CRP levels may have normal neck MR imaging, and in patients with elevated NLR and CRP levels, early protective approaches may play a preventive role in disc degeneration and cervical disc hernia development.

Highlights

Neck pain is an important public health problem, and the lifetime prevalence rate of neck pain has been reported to be 48.5% [1,2]
neutrophil-lymphocyte ratio (NLR) was significantly higher in the multi-level cervical disc herniation (CDH) group compared to the control group, while the single-level CDH and multi-level CDH had no significant difference with respect to mean serum inflammatory parameters
Higher NLR and C-reactive protein (CRP) in patients with CDH compared to patients with neck pain but normal cervical MR and the controls may be due to a developing inflammatory response

Summary

Introduction

Neck pain is an important public health problem, and the lifetime prevalence rate of neck pain has been reported to be 48.5% [1,2]. Neck pain that occurs in the absence of underlying disease such as radiculopathy is called mechanical neck pain [3]. It has been shown that pain occurs as a result of the release of local inflammatory cytokines in cervical disc herniation (CDH). These cytokines are reported as a part of pain cascade, it has been reported that inflammation around disc herniation causes an increase in C-reactive protein (CRP) levels. An increase in the plasma concentration of interleukin 6 (IL-6) produced by macrophages around the disc tissue causes an increase in CRP levels [4,5,6]

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Discussion

Conclusion