Journal of Korean Neurosurgical Society

  • 제56권3호
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  • Pages.218-223
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  • 2014
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Sequential Changes of Plasma C-Reactive Protein, Erythrocyte Sedimentation Rate and White Blood Cell Count in Spine Surgery : Comparison between Lumbar Open Discectomy and Posterior Lumbar Interbody Fusion

  • Choi, Man Kyu (Department of Neurosurgery, College of Medicine, Kyung Hee University) ;
  • Kim, Sung Bum (Department of Neurosurgery, College of Medicine, Kyung Hee University) ;
  • Kim, Kee D. (Department of Neurosurgery, University of California Davis) ;
  • Ament, Jared D. (Department of Neurosurgery, University of California Davis)
  • 투고 : 2014.06.13
  • 심사 : 2014.09.06
  • 발행 : 2014.09.28
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초록

Objective : C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often utilized to evaluate for postoperative infection. Abnormal values may be detected after surgery even in case of non-infection because of muscle injury, transfusion, which disturbed prompt perioperative management. The purpose of this study was to evaluate and compare the perioperative CRP, ESR, and white blood cell (WBC) counts after spine surgery, which was proved to be non-infection. Methods : Twenty patients of lumbar open discectomy (LOD) and 20 patients of posterior lumbar interbody fusion (PLIF) were enrolled in this study. Preoperative and postoperative prophylactic antibiotics were administered routinely for 7 days. Blood samples were obtained one day before surgery and postoperative day (POD) 1, POD3, and POD7. Using repeated measures ANOVA, changes in effect measures over time and between groups over time were assessed. All data analysis was conducted using SAS v.9.1. Results : Changes in CRP, within treatment groups over time and between treatment groups over time were both statistically significant F(3,120)=5.05, p=0.003 and F(1,39)=7.46, p=0.01, respectively. Most dramatic changes were decreases in the LOD group on POD3 and POD7. Changes in ESR, within treatment groups over time and between treatment groups over time were also found to be statistically significant, F(3,120)=6.67, p=0.0003 and F(1,39)=3.99, p=0.01, respectively. Changes in WBC values also were be statistically significant within groups over time, F(3,120)=40.52, p<0.001, however, no significant difference was found in between groups WBC levels over time, F(1,39)=0.02, p=0.89. Conclusion : We found that, dramatic decrease of CRP was detected on POD3 and POD7 in LOD group of non-infection and dramatic increase of ESR on POD3 and POD7 in PLIF group of non-infection. We also assumed that CRP would be more effective and sensitive parameter especially in LOD than PLIF for early detection of infectious complications. Awareness of the typical pattern of CRP, ESR, and WBC may help to evaluate the early postoperative course.

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피인용 문헌

  1. Strategies for the Prevention and Treatment of Surgical Site Infection in the Lumbar Spine vol.31, pp.8, 2014, https://doi.org/10.1097/bsd.0000000000000635
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  3. Changes of Biomarkers before and after Antibiotic Treatment in Spinal Infection vol.15, pp.2, 2014, https://doi.org/10.13004/kjnt.2019.15.e19