Platelet-to-lymphocyte ratio as a potential inflammatory marker for assessing the severity of vertebral destruction in patients with tuberculous spondylitis
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Abstract
Objective: To determine the association between platelet-to-lymphocyte ratio (PLR) and the severity of vertebral destruction in patients with tuberculous spondylitis.
Methods: This retrospective study was conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia. Medical records of patients diagnosed with tuberculous spondylitis between January 2017, and December 2022 were reviewed. Patients aged ≥15 years with confirmed spinal tuberculosis and complete clinical, laboratory, and radiological data were included. PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. Vertebral destruction was assessed by measuring the kyphotic angle using the Cobb method on lateral radiographs or sagittal computed tomography images. Pearson correlation and simple linear regression analyses were performed to evaluate the relationship between PLR and kyphotic angle.
Results: Out of 232 patients, 128 (55.2%) were male and 104 (44.8%) were female. The mean PLR was 209.3±139.2, while the mean kyphotic angle was 19.2±7.6°. No significant differences in haematological parameters or kyphotic angle were observed across age or gender groups (all p>0.05). PLR showed a weak but significant inverse correlation with kyphotic angle (r=-0.156, 95% CI: -0.28 to -0.03; p=0.020). Linear regression demonstrated that each one-unit increase in PLR was associated with a 0.087° decrease in kyphotic angle (β=-0.087, p=0.020), although the explanatory power was low (R²=0.024).
Conclusion: PLR demonstrated a statistically significant but weak inverse association with vertebral destruction severity in tuberculous spondylitis. Although PLR may serve as a readily available inflammatory marker, its ability to predict disease severity appears limited and requires validation in prospective multicentre studies.
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