Use of C-Reactive Protein After Spinal Surgery

Mok, Ji Oh; Pekmezci, Murat; Piper, Samantha L.; Boyd, Erin; Berven, Sigurd; Burch, Shane; Deviren, Vedat; Tay, Bobby; Hu, Serena S.

doi:10.1097/brs.0b013e318163f9ee

Cited by 111 publications

(42 citation statements)

References 29 publications

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“…Several studies have reported the usefulness of this predictor and mentioned that the combination of normal CRP, ESR, and WBC levels reliably predicts the absence of infection after elective surgery5,10,12,18).…”

Section: Discussionmentioning

confidence: 99%

“…Takahashi et al16) found that the post-operative CRP reached its peak on day 2 and remained abnormally elevated even after six weeks. And, Mok et al12) tried to derive the normal kinetics of CRP, opening the way for recognition of deviations that may indicate a complication. The kinetics seems to be conserved regardless of operation, magnitude, or region.…”

Section: Discussionmentioning

confidence: 99%

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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

Kim

et al. 2014

J Korean Neurosurg Soc

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ObjectiveC-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.MethodsTwenty 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.ResultsChanges 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.ConclusionWe 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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Kim

et al. 2014

J Korean Neurosurg Soc

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“…However, CRP peaks to a greater extent in patients with infection, but this peak can also be associated with blood loss, pre-operative CRP, and surgery in the lumbar region compared with surgery elsewhere in the spine. 20 In a series of 348 patients undergoing spinal surgery, when CRP levels were assessed at Days 1, 3 and 5 as part of the work-up to diagnose SSI, Kang et al found that elevated CRP levels had sensitivity and specificity of 100% and 97% for infection, respectively, but the positive predictive value was only 31%. 21 Fouquet et al noted that non-infected patients had significantly lower ESR and CRP levels at diagnosis and at four weeks follow-up.…”

Section: Inflammatory Markers and Imagingmentioning

confidence: 98%

Postprocedural discitis of the vertebral spine: challenges in diagnosis, treatment and prevention

McDermott

Bolger

Humphreys

2012

Journal of Hospital Infection

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“…Although it is known that CRP rises as a response to surgical tissue damage even in the absence of clinical infection [7][8][9] …”

Section: Elevation Of C-reactive Protein Levelsmentioning

confidence: 99%

“…Although mainly used by clinicians to screen for infection, serum CRP physiologically rises following surgical procedures due to the inflammatory cascade triggered by surgical tissue damage, even in the absence of infection [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Excessively elevated C-reactive protein after surgery for temporal lobe epilepsy

Woernle

Neidert

Wulf

et al. 2013

Clinical Neurology and Neurosurgery

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OBJECTIVE: We present a series of 87 patients who underwent anteromesial temporal lobe resections for therapy refractory temporal lobe epilepsy. In addition to seizure outcome, we observed excessively elevated CRP-levels in this patient population. METHODS: We followed 87 patients (m=39, f=48; mean age 33.73±12.92, range 5-67 years) who underwent surgery between July 2003 and November 2011. Seizure outcome was classified in all patients according to the ILAE-classification by . CRP levels were measured in 59 patients of the epilepsy surgery group and in a control group of 44 consecutive patients with supratentorial tumors (22 glioblastomas, 22 meningiomas). RESULTS: Clinical benefit was seen in 96.6% of the patients (ILAE classes 1-4), 80.5% were completely seizure free (ILAE class 1). Post-OP CRP values were significantly higher in the epilepsy group (n=59; mean CRP peak value: 100.86mg/l, range: 16-258mg/l) compared to the control group (n=44; mean CRP peak value: 36.85mg/l, range: 0.4-233mg/l) (p<0.001), but the correlation of mean CRP value and mean temperature peak is weak (r=0.31). CONCLUSIONS: Seizure outcome after surgery for temporal lobe epilepsy was excellent, CRP levels were excessively elevated in these patients in the absence of clinical infection and significantly higher compared to resections of supratentorial lesions. We present a series of 87 patients who underwent anteromesial temporal lobe resections for therapy refractory temporal lobe epilepsy. In addition to seizure outcome, we observed excessively elevated CRP-levels in this patient population. Methods:We followed 87 patients (m=39, f=48; mean age 33. Results:Clinical benefit was seen in 96.6% of the patients (ILAE classes 1 to 4), 80.5% were completely seizure free (ILAE class 1). Post-OP CRP values were significantly higher in the epilepsy group (n=59; mean CRP peak value: 100.86 mg/l, range: 16 -258 mg/l) compared to the control group (n=44; mean CRP peak value: 36.85 mg/l, range: 0.4 -233 mg/l) (p<0.001), but the correlation of mean CRP value and mean temperature peak is weak (r=0.31). Conclusions:Seizure outcome after surgery for temporal lobe epilepsy was excellent, CRP levels were excessively elevated in these patients in the absence of clinical infection and significantly higher compared to resections of supratentorial lesions.3

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Use of C-Reactive Protein After Spinal Surgery

Cited by 111 publications

References 29 publications

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

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

Postprocedural discitis of the vertebral spine: challenges in diagnosis, treatment and prevention

Excessively elevated C-reactive protein after surgery for temporal lobe epilepsy

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