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Spinal Surgery and Subsequent ESR and WBC Changes Pattern: A Single Center Prospective Study.

Akram Zare1, Mohammadmahdi Sabahi2,3, Hosein Safari1

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Summary

Postoperative white blood cell (WBC) counts normalize by 14 days after spinal surgery, while erythrocyte sedimentation rate (ESR) remains elevated. Monitoring these inflammatory markers is crucial for differentiating infection from inflammation.

Keywords:
Blood sedimentationDiskectomyLaminectomyLeukocytesSpinal fusion

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Area of Science:

  • Orthopedics
  • Surgical Complications
  • Inflammatory Markers

Background:

  • Postoperative inflammation and infection are common after spinal surgery.
  • Differentiating infection from inflammation is critical due to potential poor outcomes.

Purpose of the Study:

  • To analyze the temporal changes in erythrocyte sedimentation rate (ESR) and white blood cell (WBC) counts post-spinal surgery.
  • To identify variables influencing these postoperative inflammatory markers.

Main Methods:

  • Prospective study of 61 spinal surgery patients.
  • ESR and WBC counts measured preoperatively and on postoperative days 1, 3, 5, 7, and 14.

Main Results:

  • WBC counts peaked on postoperative day 1 and normalized by day 14.
  • ESR peaked on postoperative day 5 (without instrumentation) or day 7 (with instrumentation) and remained elevated at day 14.
  • ESR showed positive correlations with age, surgery duration, blood loss, and anesthesia duration.

Conclusions:

  • WBC counts return to baseline within 14 days, unlike ESR, which stays elevated.
  • The distinct patterns of WBC and ESR may aid in distinguishing postoperative inflammation from infection.