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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 11, 1478-1481.
doi: 10.1302/0301-620X.89B11.19478  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The post-operative changes in the level of inflammatory markers after posterior lumbar interbody fusion

H. Aono, MD, Orthopaedic Surgeon1; T. Ohwada, MD, Orthopaedic Surgeon2; N. Kaneko, MD, Orthopaedic Surgeon3; T. Fuji, MD, Orthopaedic Surgeon3; and M. Iwasaki, MD, Orthopaedic Surgeon4

1 Department of Orthopaedic Surgery, Osaka National Hospital, 2-1-14, Hoenzaka Chuo-ku, Osaka City, Osaka 540-0006, Japan.
2 Department of Orthopaedic Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso Amagasaki City, Hyogo, 660-8511, Japan.
3 Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka City, Osaka 553-0003, Japan.
4 Department of Orthopaedic Surgery, Osaka University Graduate, School of Medicine, 2-15 Yamadaoka Suita City, Osaka 565-0871, Japan.

Correspondence should be sent to Dr H. Aono; e-mail: h-aono{at}umin.ac.jp

Inflammatory markers such as the C-reactive protein (CRP), white blood cell count and body temperature are easy to measure and are used as indicators of infection. The way in which they change in the early post-operative period after instrumented spinal surgery has not been reported in any depth.

We measured these markers pre-operatively and at one, four, seven and 14 days postoperatively in 143 patients who had undergone an instrumented posterior lumbar interbody fusion.

The CRP proved to be the only sensitive marker and had returned to its normal level in 48% of patients after 14 days. The CRP on day 7 was never higher than that on day 4. Age, gender, body temperature, operating time and blood loss were not related to the CRP level. A high CRP does not in itself suggest infection, but any increase after four days may presage infection.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General