Korean J Spine.  2017 Sep;14(3):66-70. 10.14245/kjs.2017.14.3.66.

Variation of C-Reactive Protein and White Blood Cell Counts in Spinal Operation: Primary Fusion Surgery Versus Revision Fusion Surgery

• Kang KT
• Son DW
• Lee SH
• Song GS
• Sung SK
• Lee SW

• KMID: 2396041
• DOI: http://doi.org/10.14245/kjs.2017.14.3.66

Abstract

OBJECTIVE
Serum C-reactive protein (CRP) concentrations and white blood cell (WBC) count are commonly used to identify postoperative wound infections. We investigated whether changes in serum CRP levels and WBC counts actually differed between patients undergoing revision spinal fusion surgery and those undergoing a primary fusion.
METHODS
Patients who underwent posterolateral fusion (PLF) surgery at Pusan National University Yangsan Hospital between October 2013 and April 2015 were considered for this study. Sixty-seven patients with primary lumbar PLF (pPLF) and 21 with revision PLF (rPLF) were enrolled. A retrospective assessment of preoperative and postoperative CRP levels and WBC count was undertaken. Also, we gathered peak CRP day, and CRP normalization days. Comorbidity data were also obtained to evaluate any effects on the course of CRP and WBC count postoperatively.
RESULTS
CRP levels peaked at 3 days after surgery. The maximum CRP values recorded for each group: 4.17 (standard deviation [SD], 4.18) mg/dL and 4.88 (SD, 3.03) mg/dL for pPLF and rPLF. This difference was not statistically significant (p=0.24). A rapid fall in CRP within 5-9 days was observed for both groups.
CONCLUSION
Out of our expectation, changes in CRP levels after spinal fusion surgery follow the same course regardless of whether it is a revision operation or not. Because of this result, both the primary PLF surgery and revision PLF surgery should be monitored using CRP in the similar way and the antibiotic administration should be determined.

Keyword

C-reactive protein; Surgical wound infection; Reoperation

MeSH Terms

Busan
C-Reactive Protein*
Comorbidity
Gyeongsangnam-do
Humans
Leukocyte Count*
Leukocytes*
Reoperation
Retrospective Studies
Spinal Fusion
Surgical Wound Infection
C-Reactive Protein