关键词: 腰椎间盘突出症, 经皮椎间孔镜术, 术后后遗腰腿痛, 预测价值

Abstract: Objective To investigate the predictive value of postoperative monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1β (MIP-1β), and neutrophil to lymphocyte ratio (NLR) levels for postoperative lumbar and leg pain in patients with lumbar disc herniation (LDH) after percutaneous endoscopic lumbar discectomy.Methods A total of 181 patients with LDH who underwent percutaneous transforaminal endoscopic surgery in our hospital from January, 2021 to October, 2024 were enrolled.The patients were divided into pain group and non-pain group according to whether they had residual lumbago and leg pain at 6 months after operation.The predictive value of serum MCP-1, MIP-1β and NLR alone and in combination was analyzed by receiver operating characteristic (ROC) curve.Multivariate Logistic regression analysis was used to screen the influencing factors of low back pain and leg pain after percutaneous transforaminal endoscopic discectomy in LDH patients.Results The serum MCP-1 levels of patients in the pain group (40.04±7.14) ng/L were higher than those in the non-pain group (32.72±5.59) ng/L, and the MIP-1β levels (37.21±6.23) ng/L were higher than those in the non-pain group (26.39±5.18) ng/L, and the NLR (2.80±0.61) was higher than that in the non-pain group (1.75±0.40) (P<0.05).The ROC results showed that the AUC of the three alone in predicting postoperative low back pain and leg pain in LDH patients were 0.778, 0.775 and 0.769, respectively.The combined predicted AUC was 0.917, which was higher than that of single diagnosis (P<0.001).The results of multiple factor analysis showed that age > 60 years old, no postoperative rehabilitation training, and elevated MCP-1, MIP-1β, and NLR after surgery were independent risk factors for postoperative lumbar and leg pain in LDH patients undergoing percutaneous transforaminal endoscopy (P<0.05).Conclusion Postoperative serum MCP-1, MIP-1β and NLR have certain predictive value for low back pain and leg pain after percutaneous transforaminal endoscopic discectomy in patients with LDH, and the combination of the three has a higher predictive value.

Key words: lumbar disc herniation, percutaneous transforaminal endoscopic surgery, postoperative lower back and leg pain, predictive value