Does Preoperative Neutrophil-Lymphocyte Ratio Predict Patient-Reported Pain and Functional Outcomes at 12 Months After Lumbar Fusion?

Temidayo Osunronbi; Hiba Lusta; Balint Borbas; Agbolahan Sofela; Himanshu Sharma

doi:10.14444/8290

Article Figures & Data

Figures

Tables
Supplementary Materials

Download figure
Open in new tab
Download powerpoint
Figure 1
OR with 95% CI for ≥33% improvement in back pain according to demographic/surgical factors and preoperative neutrophil-lymphocyte ratio (NLR). ^aCompared to men, ^bcompared to smokers, and ^ccompared to single-level fusion. ODI, Oswestry Disability Index; VAS, visual analog scale.
Download figure
Open in new tab
Download powerpoint
Figure 2
OR with 95% CI for ≥40% improvement in leg pain according to demographic/surgical factors and preoperative neutrophil-lymphocyte ratio (NLR). ^aCompared to men, ^bcompared to smokers, and ^ccompared to single-level fusion. ODI, Oswestry Disability Index; VAS, visual analog scale.
Download figure
Open in new tab
Download powerpoint
Figure 3
OR with 95% CI for ≥30% improvement in ODI according to demographic/surgical factors and preoperative neutrophil-lymphocyte ratio (NLR). ^aCompared to men, ^bcompared to smokers, and ^ccompared to single-level fusion. ODI, Oswestry Disability Index; VAS, visual analog scale.

View popup

Table 1

Baseline demographic/surgical data.

Variables (N = 53)	Median (Interquartile Range)^a
Age, y	52 (47–66)
Sex
Male	22
Female	31
Smoker
Yes	6
No	47
Body mass index, kg/m² (n = 48)	29.7 (26.5–32.6)
Charlson Comorbidity Index	1 (0–2)
Indication for surgery
Spondylolisthesis	46
Lumbar stenosis	4
Lumbar disc herniation	2
Degenerative disc disease	1
No. of spinal levels operated
1	26
2	27
Baseline VAS back pain (n = 51)	8 (7–9)
Baseline VAS leg pain (n = 51)	8 (6–9)
Baseline ODI	56 (39–65)
Baseline NLR	1.9 (1.4–2.4)

Abbreviations: NLR, neutrophil-lymphocyte ratio; ODI, Oswestry Disability Index; VAS, visual analog scale.
^aPresented as absolute count for categorical variables and median (interquartile range) for continuous variables.

View popup

Table 2

OR for improvement in VAS back pain, leg pain, and ODI scores ( ≥33% for VAS back pain, ≥40% for VAS leg pain, and ≥30% for ODI) at 12 months after lumbar fusion.

Variables	Improvement in VAS Back Pain				Improvement in VAS Leg Pain				Improvement in ODI
Variables	Yes^a (n = 39)	No^a (n = 11)	OR (95% CI)	P	Yes^a (n = 42)	No^a (n = 7)	OR (95% CI)	P	Yes^a (n = 38)	No^a (n = 15)	OR (95% CI)	P
Age, y	58 (49–66)	47 (42–59)	1.04 (0.99–1.10)	0.16	52 (48–66)	47 (39–63)	1.04 (0.98–1.11)	0.24	58 (49–68)	50 (42–66)	1.02 (0.97–1.06)	0.47
Sex
Female	24	6	1.33 (0.35–5.15)	0.68	28	1	12.0 (1.3–110)	0.03*	22	9	0.92 (0.27–3.10)	0.89
Male	15	5	1 (Reference)	0.68	14	6	1 (Reference)	0.03*	16	6	1 (Reference)	0.89
Smoker
Yes	4	1	1 (Reference)	0.91	4	1	1 (Reference)	0.70	5	1	0.47 (0.05–4.41)	0.51
No	35	10	0.88 (0.09–8.74)	0.91	38	6	1.58 (0.15–16.7)	0.70	33	14	1 (Reference)	0.51
Body mass index, kg/m²	28.8 (26.5–33.0)	28.2 (23.3–32.3)	1.07 (0.92–1.24)	0.40	28.6 (25.5–33.1)	31.2 (30.2–33.0)	1.01 (0.85–1.21)	0.89	30.1 (27.1–33.5)	27.1 (22.6–31.7)	1.15 (0.99–1.33)	0.06
Charlson Comorbidity Index	1 (0–2)	1 (0–1)	1.42 (0.74–2.69)	0.29	1 (0–2)	0 (0–2)	1.73 (0.74–4.04)	0.21	1.5 (1–2)	1 (0–2)	1.24 (0.75–2.07)	0.41
Number of spinal levels
1	18	7	1 (Reference)	0.31	22	3	1 (Reference)	0.64	19	7	0.88 (0.26–2.90)	0.83
2	21	4	2.04 (0.51–8.12)	0.31	20	4	0.68 (0.14–3.43)	0.64	19	8	1 (Reference)	0.83
Baseline VAS back pain	8 (8–9)	7 (5–9)	1.56 (1.04–2.35)	0.03*	8 (7–9)	9 (4–10)	1.23 (0.81–1.88)	0.33	8 (7–9)	9 (7–10)	1.01 (0.71–1.44)	0.96
Baseline VAS leg pain	8 (6–9)	7 (3–9)	1.16 (0.89–1.51)	0.28	8 (6–9)	9 (5–9)	0.97 (0.68–1.40)	0.89	8 (6–9)	7 (4.5–9)	1.10 (0.86–1.41)	0.45
Baseline ODI	58 (36–64)	56 (44–66)	0.99 (0.95–1.03)	0.64	51 (38–64)	66 (62–68)	0.96 (0.91–1.02)	0.19	55 (37–65)	62 (44–66)	0.99 (0.95–1.03)	0.66
Baseline NLR	2.0 (1.4–2.7)	2.0 (1.8–2.1)	0.94 (0.69–1.29)	0.72	2.0 (1.6–2.7)	1.8 (1.4–2.1)	1.62 (0.52–5.00)	0.40	2.0 (1.4–2.7)	1.8 (1.4–2.1)	1.03 (0.74–1.44)	0.87

Abbreviations: NLR, neutrophil-lymphocyte ratio; ODI, Oswestry Disability Index; VAS, visual analog scale.
^aPresented as absolute numbers for categorical variables and median (interquartile range) for quantitative variables. P value determined by binary logistic regression.
^bStatistically significant at 5% significance level.