Relationship between neutrophil lymphocyte ratio and interleukin-17A levels with pain intensity and degree of herniated nucleus pulposus in low back pain patients

Abstract

Background and objectives. Low back pain (LBP) affects 80% of individuals globally and causes significant disability. Intervertebral disc disorders (IDDs), a major LBP contributor, result in chronic pain, impaired function, and economic challenges. Degenerative processes, inflammatory cytokines, and disrupted extracellular matrix play key roles in IDD pathology. This study aims to investigate the relationship between serum neutrophil-lymphocyte ratio (NLR) and interleukin-17A (IL-17A) levels in patients with LBP due to herniated nucleus pulposus (HNP), neuropathic, and nociceptive pain intensity. Materials and methods. This observational cross-sectional study was conducted in patients with HNP. HNP diagnosis is based on radiological findings. The NRS assessment tool was used to measure pain intensity. NLR was calculated from routine blood tests, and IL-17A levels were measured with an ELISA method. Results. This study included 62 HNP patients, predominantly male (51.6%), with a mean age of 45.5 years. HNP severity showed extrusion (40.3%), protrusion (38.7%), and bulging (21.0%). The median NLR was 2.34, and IL-17A was 129.65 pg/mL. NLR correlated positively with nociceptive (r = 0.472) and neuropathic NRS (r = 0.345), while IL-17A correlated with nociceptive (r = 0.518) and neuropathic NRS (r = 0.390). NLR significantly differed across HNP degrees (p = 0.010). However, IL-17A showed no significant result (p = 0.144). Conclusions. Significant correlations were found between NLR levels and nociceptive/neuropathic pain NRS in HNP patients, and IL-17A levels. NLR varied significantly across HNP severity, suggesting its potential as a biomarker. However, IL-17A showed no significant relationship with HNP severity, indicating its role in inflammation rather than disease progression.

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