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Postoperative Nonpathologic Fever After Spinal Surgery: Incidence and Risk Factor Analysis
Junghan Seo1, Jin Hoon Park2, Eun Hee Song3
1Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
World Neurosurgery
|April 6, 2017
Summary
Delayed postoperative fever after spinal surgery is common and often not due to infection. Key risk factors include specific surgical approaches, trauma/tumor cases, and longer operative times. Awareness is crucial for spinal surgeons.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Infectious Disease
Background:
- Delayed postoperative fever is a concern after spinal surgery.
- Surgical-site infection is often suspected but not always the cause.
- This study investigates non-infectious causes of delayed fever post-spinal procedures.
Purpose of the Study:
- To determine the incidence of delayed postoperative fever after spinal surgery.
- To characterize the clinical presentation of this fever.
- To identify risk factors associated with its development.
Main Methods:
- Retrospective chart review of 250 patients undergoing spinal surgery.
- Fever defined as temperature >37.8°C from postoperative day 4 onwards.
- Data collected included patient demographics, comorbidities, surgical details, and perioperative factors.
Main Results:
- 33 out of 250 patients (13.2%) developed delayed postoperative fever.
- Significant risk factors identified: posterior approach with anterior body removal/mesh graft, trauma/tumor surgery (vs. degenerative), and prolonged operative time.
- No association found with age, sex, diabetes, hypertension, smoking, or transfusion.
Conclusions:
- Delayed postoperative fever is a relatively common occurrence after spinal surgery.
- Fever in this context is often non-pathologic and not related to surgical-site infection.
- Spinal surgeons should consider non-infectious etiologies for late-onset fever.