Abstract
Background Preoperative neutrophil-lymphocyte ratio (NLR) has been described in various fields to predict pain outcomes, but its prognostic utility for pain/functional outcomes after spine surgery is unclear.
Objective To determine the relationship between preoperative NLR and pain/functional outcomes at 12 months after lumbar fusion.
Methods We performed a single-center retrospective study of 53 patients who underwent lumbar fusion and collected demographic data including age, sex, body mass index, smoking status, spinal levels operated, and preoperative NLR. Visual analog scale (VAS) for back and leg pain and Oswestry Disability Index (ODI) at baseline and 12 months after lumbar fusion were also collected. The outcome measures were the occurrence of a clinically important improvement in VAS and ODI scores at 12 months. Binary logistic regression was used to estimate the associations of demographic factors and NLR with improvement in VAS and ODI scores. A P value of <0.05 was considered statistically significant.
Results There were no statistically significant associations between preoperative NLR and improvement in VAS or ODI scores. A unit increase in baseline VAS back pain score was associated with a 56% increase in the odds of improvement in back pain (OR: 1.56, 95% CI: 1.04–2.35, P = 0.03). Compared to male patients, female patients had 12 times greater odds of an improvement in leg pain (OR: 12.0, 95% CI: 1.3–110, P = 0.03).
Conclusion Preoperative NLR does not predict patient-reported pain/functional outcomes at 12 months after lumbar fusion. Large-scale prospective multicenter studies are warranted to confirm our findings.
Footnotes
↵† Temidayo Osunronbi and Hiba Lusta are joint first authors.
Funding The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests The authors report no conflicts of interest in this work.
Ethics Approval This retrospective study was registered and approved by the Clinical Audit Department at University Hospitals Plymouth NHS Trust (Study registration number: CA_2020-21-130. Approved on 12 October 2020). All applicable international, national, and institutional guidelines for the care and use of the patient’s anonymized clinical data were followed.
Data Availability The collected raw data of demographics, operative factors, preoperative NLR, and VAS pain scores are presented in Supplemental Material 1.
- This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2022 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.