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Early-phase enhanced inflammatory reaction after spinal instrumentation surgery.
J Takahashi1, S Ebara, M Kamimura
1Department of Orthopaedic Surgery, School of Medicine, Shinshu University, Nagano, Japan. jtaka@hsp.md.shinshu-u.ac.jp
Spine
|July 28, 2001
Summary
Spinal instrumentation surgery causes higher inflammatory responses than surgery without instrumentation. Elevated C-reactive protein and white blood cell counts after 4-7 days can indicate infection following spinal instrumentation.
Area of Science:
- Orthopedic Surgery
- Surgical Infection
- Inflammatory Markers
Background:
- C-reactive protein (CRP) is valuable for detecting postoperative infections in other surgeries.
- The impact of spinal instrumentation on postoperative inflammatory markers is not well-established.
Purpose of the Study:
- To assess the effect of spinal instrumentation on postoperative inflammatory reactions.
- To identify early indicators of wound infection after spinal instrumentation surgery.
Main Methods:
- Prospective study comparing spinal decompression surgery without instrumentation (n=36) to surgery with instrumentation (n=37).
- Measured erythrocyte sedimentation rate (ESR), CRP, white blood cell count (WBC), and body temperature pre- and post-surgery up to 42 days.
Main Results:
- Patients with spinal instrumentation showed significantly higher inflammatory markers (CRP, ESR, WBC, temperature).
- CRP and ESR peaks strongly correlated with instrumentation use.
- Infected patients exhibited a secondary rise in CRP, WBC, and temperature 4-11 days post-surgery, with prolonged ESR elevation.
Conclusions:
- Spinal instrumentation significantly elevates postoperative inflammatory markers like ESR and CRP.
- A secondary increase in CRP, WBC, and temperature between postoperative days 4-7 suggests potential infection.