Original Research Article
Year: 2022 | Month: January | Volume: 12 | Issue: 1 | Pages: 137-146
DOI: https://doi.org/10.52403/ijhsr.20220120
Degrees of Canal Stenosis, Levels of Interleukin-6 (IL-6) And C-Reactive Protein (CRP) Preoperative as Predictors of the Output of Neurogenic Claudication Outcome Score (NCOS) 8 Weeks Post-Decompression-Stabilization-Fusion in Degenerative Lumbar Spinal Stenosis Patients
Nyoman Gede Bimantara1, I Ketut Suyasa2, I Gede Eka Wiratnaya2, Iglna Artha Wiguna2, Elysanti Dwi Martadiani3, Marsha Ruthy Darmawan4
1Resident, Orthopedic and Traumatology Department, Faculty of Medicine Udayana University, RSUP. Sanglah General Hospital, Bali.
2Consultant, Orthopedic and Traumatology Department, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali.
3Consultant, Radiology Department, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali.
4Resident, Radiology Department, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali.
Corresponding Author: I Gede Eka Wiratnaya
ABSTRACT
Introduction: Lumbar Spinal Stenosis (LSS) or spinal stenosis is the most common spinal disease in elderly patients. LSS is also one of the leading causes of spinal surgery in the world. The problem that is often encountered is the limited predictor of outcomes that are considered affordable and accurate, so as to provide education to patients about possible output after the surgery process is carried out. Therefore, a predictor is needed that is considered accurate and affordable such as the degree of measurable canal stenosis of Magnetic resonance imaging (MRI), serum levels of C-Reactive Protein (CRP) and Interleukin-6 (IL-6)
Method: This study used a prospective cohort design conducted to compare Neurogenic Claudication Outcome Score scores among people with degenerative lumbar canal stenosis whose post-decompression-stabilization-fusion had higher degrees of canal stenosis (measured through Schizas grading of Magnetic resonance Imaging/MRI) examinations), as well as high pre-operative CRP and IL-6 levels with those with normal CRP and IL-6 levels. From the population of lumbar spinal stenosis, the selection of samples was conducted consecutively sampling. After that, statistical tests in the form of descriptor tests, normality tests, risk factor assessments with 2x2 cross tabulation, and proportion comparison analysis using the Fisher Exact test.
Result: Severe lumbar canal stenosis degrees resulted in worse NCOS 8 weeks postoperative than mild degrees of lumbar canal stenosis, with statistically significant differences (p=0.008; p < 0.05) and RR 6.4 (0.99-41.08). High CRP levels resulted in worse NCOS 8 weeks postoperative than mild lumbar degrees of canal stenosis, with statistically significantly differences (p=0.008; p < 0.05) and RR 6.4 (0.99-41.08). High pre-operative IL-6 levels resulted in worse NCOS 8 weeks postoperative than normal pre-operative IL-6 levels with statistically significantly differences (p=0.002; p < 0.05) and RR 8 (1.24-51.50).
Conclusion: Degrees of preoperative (mild) canal stenosis, high pre-operative CRP levels, and high levels of pre-operative IL-6 were predictors for better 8-week NCOS scores in patients with post-decompression-stabilizing-fusion degenerative LSS disease.
Key words: Degenerative lumbar spinal stenosis, IL-6, CRP, canal degree stenosis, NCOS.