Inflammatory Events in Patients with Sagittal Imbalance through Platelet-Associated Inflammation

To determine whether platelet-associated inflammation parameters (PAIP) could be useful for evaluating inflammation in sagittal imbalance (SI) by investigating its relationship with pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), lumbar lordosis (LL) and thoracic kyphosis (TK).

The study included 57 patients (19 males, 38 females) who were diagnosed with SI and 44 healthy control subjects. Spinal sagittal balance was evaluated using digitalized-standing lumbar lateral radiographs of the patients. All parameters including SS, PI, LL and PT were evaluated through from the lateral radiographs.

In the analysis, Mean Platelet Volume (MPV) (10.6 ± 0.9; p < 0.0001), Platelet Distribution Width (PDW) (12.7 ± 2.2; p < 0.001) and Platelet Distribution Width (RDW) (41.9 ± 4.4; p < 0.0001) were observed to be much higher in the SI than in the control. The neutrophil-lymphocyte ratio (NLR) was higher in the SI group (p=0.033), and no difference was determined in respect of the platelet-lymphocyte ratio (PLR) (p > 0.05). The PT had a positive correlation with hospital length of stay in SI patients (r=0.655; p=0.008). MPV showed a strong positive correlation with comorbidity (r=0.715; p=0.001). A positive correlation was determined between NLR and PLR (r=0.692; p=0.002), and between MPV and RDW (r=0.788; p=0.001). No correlation was determined between the PAIP and radiological measurements (PI, PT, SS) that were used for SI.

The results suggest that the neurosurgical approach should cover not only the sagittal parameters and their angles but also PAIP showing inflammatory events originating from platelets.