Asian Spine J.  2013 Sep;7(3):173-177. 10.4184/asj.2013.7.3.173.

Diagnostic Usefulness of White Blood Cell and Absolute Neutrophil Count for Postoperative Infection after Anterior Cervical Discectomy and Fusion Using Allograft and Demineralized Bone Matrix

• Kong CG
• Kim YY
• Ahn CY
• Park JB

• KMID: 2270428
• DOI: http://doi.org/10.4184/asj.2013.7.3.173

Abstract

STUDY DESIGN: Prospective study. PURPOSE: We investigated normative temporal levels of white blood cell (WBC) and absolute neutrophil count (ANC) in uncomplicated anterior cervical discectomy and fusion (ACDF) using allograft and demineralized bone matrix (DBM). OVERVIEW OF LITERATURE: No study has investigated the diagnostic usefulness of WBC and ANC for postoperative infection following ACDF using allograft and DBM.
METHODS
Blood samples of 85 patients, who underwent one or two-level ACDF, were obtained and evaluated before surgery and on the first, third, fifth, seventh, fourteenth, thirtieth, and ninetieth postoperative days. No infection was found in all patients for at least one year follow-up period.
RESULTS
Mean WBC and ANC values increased significantly and reached peak levels on the first postoperative day. The peaked levels rapidly decreased but still remained elevated above the preoperative levels on the third postoperative day. The levels returned close to the preoperative levels on the fifth postoperative day. The mean WBC and ANC values did not get out of their normal reference ranges throughout the follow-up periods. One-level and two-level ACDF exhibited a similar course of postoperative changes in WBC and ANC values and no significant difference in mean levels of WBC and ANC throughout the follow-up periods.
CONCLUSIONS
Uncomplicated ACDF using allograft and DBM showed normal values of WBC and ANC during the early postoperative period. Therefore, significant abnormal values of WBC and ANC at an early postoperative period suggest the possibility of the development of acute postoperative infection after ACDF using allograft and DBM.

Keyword

White blood cell; Absolute neutrophil count; Anterior cervical discectomy and fusion; Allograft; Demineralized bone matrix

MeSH Terms

Bone Matrix
Diskectomy
Follow-Up Studies
Humans
Leukocytes
Neutrophils
Postoperative Period
Prospective Studies
Transplantation, Homologous