title: Discriminating extrusive and bulging disk herniations by using serum hs CRP.
abstract: It has been proposed that because there is inflammation around the nerve roots in disk herniation, there might be an association between serum C Reactive Protein (CRP) with this disease. This study aimed to distinguish between two forms of disk herniation (extrusion, bulging) by comparing the level of serum high-sensitivity CRP (hs CRP). In this perspective study, a total of 62 candidates for lumbar disk herniation surgery were recruited in Tabriz Imam Reza Hospital from 2012 to 2013. The patients categorized in two groups; with extrusion (n = 34) and with bulging (n = 28). Pre-operative serum hs CRP was measured by turbidimetric immunoassay. Both extrusion and bulging groups were matched for their patients' sex (males: 61.8% vs. 57.1%, respectively; p = 0.71) and age (mean: 52.22 +/- 7.32 years vs. 49.69 +/- 9.40 years, respectively; p = 0.48). The mean serum hs CRP was significantly higher in the extrusion group (3.56 +/- 2.90 with a range of 0.1 to 19 mg dL(-1) vs. 0.74 +/- 0.91 with a range of 0 to 5 mg dL(-1); p < 0.001). Based on the results of the receiver operator characteristics (ROC) cure, a cut-off point of hs CRP was =2.6 was highly indicative of extrusion, with a sensitivity and specificity of 66 and 63%, respectively. Based on the findings of the present study, the mean serum hs CRP is significantly higher in the patients with extrusive disk herniation vs. those with bulging. The proposed cut-off point may be useful as a preliminary indicator of the type of herniation, before more detailed imaging becomes available.
authors: Department of Pathology, Tabriz University of Medical Sciences, Sina Hospital, Tabriz, Iran.
authors: S
authors: S
authors: Talghini
authors: Department of Pathology, Tabriz University of Medical Sciences, Sina Hospital, Tabriz, Iran.
authors: Amir
authors: A
authors: Vahedi
authors: Department of Neurosurgery, Tabriz University of Medical Sciences, Imam Reza Hospital, Tabriz, Iran.
authors: I
authors: I
authors: Lotfinia
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007118:Immunoassay; D007403:Intervertebral Disc / Q000378:metabolism / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism; D007405:Intervertebral Disc Displacement / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism; D008159:Lumbar Vertebrae / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D011446:Prospective Studies
chemical_list: D002097:C-Reactive Protein