The Clinical Analysis of Postoperative Discitis and ESR Changes Following Lumbar Disc Operations

Yee, Gi Taek; Kim, Tae Sung; Lim, Young Jin; Rhee, Bong Arm; Kim, Gook Ki; Leem, Won

Abstract

From March 1986 to December 1994, 30 out of 1930 patients with lumbar HIVD or lumbar stenosis were diagnosed as discitis after laminectomy(total or hemilaminectomy) and discectomy in the Department of Neurosurgery, Kyung Hee University Hospital. The author had analysed the clinical features and diagnostic procedure of discitis. Furthermore, changes in ESR were continuously monitored in patients following laminectomy, with or without complications. The incidence of discitis following lumbar laminectomy was relatively rare(1.6%). Severe back pain and muscle spasm were characteristic symptoms. Patients with discitis showed elevations of ESR to its maximum after 2 weeks and then decreased slowly. However patients without discitis reached maximum rate in the 9th day and decreased rapidly to within normal value 2 weeks after. Therefore, continuous increase of ESR after operation strongly suggests discitis and we believe that serial examination of ESR will be helpful in the early detection of discitis. Compared with discitis patients, to determined the normal changes of the ESR after laminectomy, 100 patients(50 females, 50 males) were randomly selected and serial erythrocyte sedimentation rate were recorded during the first 4 weeks after operation. The parameters which affect postoperative ESR were operation time, sex, age, and postoperative steroid therapy. The operative time, sex and postoperative steroid therapy had no effect on the postoperative ESR changes significantly(p>0.05), but the more increase of age(over 40 years), the ESR was elevated significantly(p<0.05).