High-sensitivity analysis of serum C-reactive protein in young patients with lumbar disc herniation

Abstract

We measured the serum concentration of C-reactive protein (CRP) by a high-sensitive method in patients with lumbar disc herniation. There were 48 patients in the study group and 53 normal controls. The level and type of herniation were evaluated. The clinical data including the neurological findings, the angle of straight leg raising and post-operative recovery as measured by the Japanese Orthopaedic Association (JOA) score, were recorded. The high-sensitive CRP (hs-CRP) was measured by an ultrasensitive latex-enhanced immunoassay. The mean hs-CRP concentration was 0.056 +/- 0.076 mg/dl in the patient group and 0.017 +/- 0.021 mg/dl in the control group. The difference was statistically significant (p = 0.006). There was no other correlation between the hs-CRP concentration and the level and type of herniation, or the pre-operative clinical data. A positive correlation was found between the concentration of hs-CRP before operation and the JOA score after. Those with a higher concentration of hs-CRP before operation showed a poorer recovery after. The significantly high concentration of serum hs-CRP might indicate a systemic inflammatory response to impingement of the nerve root caused by disc herniation and might be a predictor of recovery after operation.

Cardiovascular and lifestyle risk factors in lumbar radicular pain or clinically defined sciatica: a systematic review

“…In the other two studies [26,45], serum hs-CRP level was higher in patients with lumbosciatic syndrome or herniated lumbar disc than in controls. In addition, patients with a higher preoperative hs-CRP level had poorer postoperative recovery [45]. In one of these studies [26], cases were matched to controls by age and gender, while in the other study [45], the difference in hs-CRP level between cases and controls was not controlled for potential confounding factors.…”

“…Twelve studies had no or minor bias, 3 studies had one source of moderate bias [25,33,49] and 4 studies [20,45,47,51] had at least 1 source of severe bias or 2 of moderate bias. The baseline population was the same as in the study by Riihimäki [38] …”

“…One study found no difference in serum hs-CRP level between patients with acute disc herniation-induced lumbosciatic pain and healthy controls [9]. In the other two studies [26,45], serum hs-CRP level was higher in patients with lumbosciatic syndrome or herniated lumbar disc than in controls. In addition, patients with a higher preoperative hs-CRP level had poorer postoperative recovery [45].…”

“…In addition, patients with a higher preoperative hs-CRP level had poorer postoperative recovery [45]. In one of these studies [26], cases were matched to controls by age and gender, while in the other study [45], the difference in hs-CRP level between cases and controls was not controlled for potential confounding factors. A cross-sectional study showed no association between serum cholesterol level and lumbosacral radicular syndrome [25].…”

C-Reactive Protein

“…In this study we could not find any correlation of the raised CRP level they age , sex , ESR , WBC count , body temperature duration of surgery blood transfusion [36] with exception of Orrego LM et al [37] who noticed that more complex surgical procedure had higher CRP level and explained due to the amount of tissue trauma. Sugimorik et al [38] showed no correlation between the high CRP concentration and the level, type of lumbar disc herneation or the preoperative clinical data. Thelander et al [39] noticed that peak levels were not related to bleeding, transfusion, operation time, administered drugs, age or sex However, it has not been demonstrated if resolution of the signs and symptoms of postoperative spinal wound infections in patients who are being treated with intravenous antibiotics correlates with these markers.…”