The Importance of C-reactive protein levels for Surgical Decision and Determination of Response to Conservative Therapy in Patients with Acute Sciatica


Eryılmaz F.

Annals of Medical Research, cilt.27, sa.9, ss.2414-2420, 2020 (TRDizin) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 27 Sayı: 9
  • Basım Tarihi: 2020
  • Doi Numarası: 10.5455/annalsmedres.2020.04.312
  • Dergi Adı: Annals of Medical Research
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.2414-2420
  • Yozgat Bozok Üniversitesi Adresli: Evet

Özet

Aim: We aimed to determine C-reactive protein (CRP) levels in patients with intervertebral disc disease (IDD) and to evaluate these

patients’ radiological and clinical characteristics.

Material and Methods: A total of 102 patients were divided into four groups according to lumbar MRI results using the Macnab

classification: bulging, protrusion, extrusion-sequestration, and normal. Straight leg raising test (SLR) and visual analogue scale

(VAS) were used for clinical evaluation. Patients with bulging and protrusion were treated with conservative therapy within 5-10

days and bed-rest. Blood samples, SLR values and VAS scores were obtained from these patients before and after conservative

therapy. The extrusion-sequestration group underwent lumbar spinal surgery. Medical treatment was not applied to this group and

blood samples were collected only preoperatively. Individuals with normal MRI findings and no spinal complaints were evaluated as

controls.

Results: CRP levels were found to be 6.61 ± 7.78 in controls, 6.62 ± 5.28 in the bulging group, 11.50 ± 21.71 in the protrusion

group and 17.18 ± 48.22 in the extruded-sequestration group (p=0.321). CRP levels were significantly decreased after treatment in

the bulging group (p=0.001). Positive correlations were found between post-treatment VAS scores and pre-treatment WBC in the

protrusion group, and with CRP levels in the bulging group.

Conclusion: Although no statistically significant difference was determined, we observed higher mean serum CRP levels in the

surgical group (extrusion-sequestration). We believe that further studies must be performed to determine whether serum CRP levels

can be used as a prognostic marker in surgical decision making.