Association of Hematologic Parameters with Post-operative Outcomes in Patients Undergoing Lumbar Disc Herniation Surgery

Abstract

Objective: In this study, we aimed to determine whether hematologic parameters have an effect on the post-operative outcomes in patients operated for lumbar disc herniation. Material and Methods: The study was conducted in the retrospective cohort design in the Department of Neurosurgery of Ankara Güven Hospital and included patients who were hospitalized and treated with the diagnosis of Lumbar Disc Herniation (LDH) between 01.01.2019 and 31.12.2020. Patients' pre-operative hematologic parameters, which were routinely studied preoperatively, and Visual Analogue Scale (VAS) scoring records, which were routinely used to monitor pain levels, were retrospectively reviewed, and the outpatient clinic notes of the patients within 6 months post-operatively were evaluated. Results: Among 117 patients hospitalized with LDH over a 1-year period, 87 patients were included in the study. 30 LDH patients, owning factors that may affect wound healing and platelet function (active infection/diabetes mellitus, antiaggregants/anticoagulants) were excluded. When Hb was examined from the pre-operative hematological parameters, anemia was detected in 6 (7%) of 87 patients; however, it had no significant effects on VAS scores and surgical outcomes (p>0.05). Pre-operative Neutrophil-to-Lymphocyte Ratio (NLR) was elevated in 17 (20%) of the 87 patients, and the VAS score of these patients was found to be 1.5-fold higher than normal patients (p=0.031). Post-operative complications (infection, hemorrhage and cerebrospinal fluid fistula)  were detected in 5 (6%) of the 87 patients who underwent surgery, and it was found that the pre-operative NLR values were high in these 5 patients. It was also found that high NLR increased the risk of post-operative complications 1.4-fold in patients (p=0.002). No results could be obtained regarding the platelet values because this parameter was within the normal range preoperatively in all patients. Conclusion: In the present study, the effects of hematological parameters on lumbar disc surgery were investigated, and it was concluded that elevated NLR values increased wound site infection among post-operative complications and VAS scores.