C-reactive protein in spinal surgery: more predictive than prehistoric

Area of Science:

• Orthopedics
• Infectious Disease
• Biochemistry

Background:

• Surgical site infections (SSI) are serious complications following spinal surgery, particularly dorsal spondylodesis.
• Early and accurate detection of postoperative SSI is critical for patient outcomes.

Purpose of the Study:

• To evaluate the prognostic value of C-reactive protein (CRP) kinetics in predicting SSI after open reduction and dorsal spondylodesis.
• To identify specific CRP patterns indicative of infectious complications.

Main Methods:

• Retrospective cohort study of 192 patients undergoing dorsal spondylodesis from 2016-2018.
• Analysis of serological and clinical characteristics, focusing on CRP levels for 20 days post-surgery.
• Statistical analysis including binary logistic regression and one-phase decay exponential regression.

Main Results:

• Significantly higher CRP levels were observed on postoperative days 7 and 8 in patients who developed SSI.
• A second CRP peak, failure to decline, and a maximum CRP >225 mg/l predicted SSI with high sensitivity (92.9%) and specificity (78.2%).
• Regression models demonstrated predictive capabilities for infectious complications.

Conclusions:

• Postoperative CRP kinetics are highly valuable for detecting SSI after dorsal spondylodesis.
• Specific CRP level patterns can facilitate early SSI detection in clinical practice.
• This monitoring approach can improve patient management and outcomes.