Serum interleukin-6 response after spinal surgery: estimation of surgical magnitude

Serum interleukin-6 (IL-6) has been used for quantitative estimation of the surgical magnitude of major cardiac and thoracoabdominal surgery, but there have been few studies assessing IL-6 as a marker of surgical magnitude of spinal surgery.

We investigated the changes in IL-6 response in comparison to other parameters of surgical magnitude and spinal surgery procedures. The study included 40 patients electively undergoing spinal surgery. The patients were divided into four groups: lumbar laminectomy with posterolateral fusion (PLF), lumbar laminotomy, lumbar open discectomy, and cervical laminoplasty. Serum IL-6, C-reactive protein (CRP), creatine kinase (CK), and the white blood cell (WBC) count were determined in venous blood before surgery, at the end of surgery, and 6 h and the first, third, and seventh days after surgery.

Serum IL-6 peaked on the first day and returned to a normal value by the seventh day. The peak IL-6 concentrations on the first day after surgery significantly correlated with CRP, CK, duration of surgery, and estimated blood loss. Regarding lumbar surgeries, the peak IL-6 for laminectomy/PLF was significantly higher than that for laminotomy/open discectomy or for cervical laminoplasty.

Serum IL-6 on the first day varied depending on the surgical procedure used. Therefore, it might be a quantitative marker of surgical magnitude following spinal surgery.