Early-phase enhanced inflammatory reaction after spinal instrumentation surgery
Autor: | Sohei Ebara, Tetsuya Kinoshita, Yo Sheena, Mikio Kamimura, Yohei Yuzawa, Jun Takahashi, Kunio Takaoka, Hidehiro Itoh |
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Rok vydání: | 2001 |
Předmět: |
Adult
Male medicine.medical_specialty Decompression Inflammation Blood Sedimentation Body Temperature Leukocyte Count White blood cell medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine Rachis Aged Aged 80 and over biology medicine.diagnostic_test business.industry C-reactive protein Middle Aged medicine.disease Decompression Surgical Surgery medicine.anatomical_structure C-Reactive Protein Spinal Fusion Anesthesia Spinal decompression Erythrocyte sedimentation rate biology.protein Female Neurology (clinical) medicine.symptom business Abdominal surgery |
Zdroj: | Spine. 26(15) |
ISSN: | 0362-2436 |
Popis: | Study design The erythrocyte sedimentation rate, C-reactive protein, white blood cell count, and body temperature were measured prospectively in patients after two types of spinal surgery without complications and three cases of infection after spinal instrumentation surgery. Objectives To investigate the effects of instrumentation on postoperative inflammatory reaction, and to describe early detection of postoperative wound infection. Summary of background data In thoracic and abdominal surgery as well as hip arthroplasty, C-reactive protein has proved more valuable than erythrocyte sedimentation rate for early detection of postoperative infectious complications. It has not yet been established, however, how inflammatory parameters change after surgery when spinal instruments have been inserted into the body. Methods For this study, two groups of patients were examined: a control group that underwent spinal decompression surgery without instrumentation (n = 36) and another group that underwent spinal decompression and fusion surgery with spinal instrumentation (n = 37). The erythrocyte sedimentation rate, C-reactive protein, white blood cell count, and body temperature were recorded 1 day before surgery and on days 0 to 4, 7, 11, 14, 21, 28, and 42 after surgery. Results Inflammatory indexes (i.e., C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and body temperature) were significantly higher for the surgery with instrumentation than for the spinal decompression surgery without instrumentation. Multiple regression analysis showed that C-reactive protein and erythrocyte sedimentation rate peaks significantly correlated with the use of instrumentation (C-reactive protein: P = 0.000257, erythrocyte sedimentation rate: P = 0.000132). In the patients with infection after spinal instrumentation surgery, C-reactive protein, white blood cell count, and body temperature started to increase again 4 to 11 days after surgery. The elevation of erythrocyte sedimentation rate levels was prolonged. Conclusions Erythrocyte sedimentation rate and C-reactive protein display a significantly higher reaction after spinal surgery with instrumentation. Renewed elevation of C-reactive protein, white blood cell count, and body temperature after postoperative days 4 to 7 may be a critical sign of postoperative infection. |
Databáze: | OpenAIRE |
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