The Clinical Predictive Value of the Neutrophil to Lymphocyte Ratio as a Biomarker in Lumbar Disc Herniation

Objective: Low back pain is a frequently seen problem in the society and causes loss of labor. Although etiology of lumbar disc herniation is multi-factorial it is known that it is determinant for the etiology of intervertebral disc degeneration herniation. In recent studies, it has been shown that it has an efficient role in the process of inflamation and inflamatory cytokine disc. We aimed to investigate the association between the neutrophil to Lymphocyte Ratio  level as an inflammatory biomarker in patients with lumbar disc herniation. Methods: 394 patients between the age of 18-80 applying to our center because of low back pain complaint and having lumbar MR were included in the study. The patients were divided into two groups as having lumbar disc hernia and not having based on the lumbar MR result. Blood samples were taken from all patients during application and neutrophil lymphocyte rates were calculated.  Results.  Average age of group with lumbar disc hernia was 46 and 55 of these cases were female and 45 of them were male. N/L rate was measured as 3.81+/-1.85 (p=0.001) in the group having lumbar disc hernia and significant difference compared to the control group was noted. It was found out that lifting weight (β=0.121 95% Cl (0.052-0.281), P<0.001),BMI (β=0.226, 95% Cl (0.080-0.640) P=0.005), DM (β=0.268 95% Cl (0.074-0.969), P=0.045), smoking (β=3.226 95% Cl (1,343-7.749), P<0.009), educational background (β=5.268 95% Cl (1.941-9.796), P=0.001) and NLR (β=1.302 95% Cl (1.013-1.673), P=0.039) were the independent predictors in the presence of lumbar disc herniation. Conclusion: NLR may be used as a simple and reliable premise independent predictor of lumbar disc herniation in patients with low back pain.

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