The trend of change and clinical significance of early-phase inflammatory indices after cervical fixation

doi:10.3969/j.issn.2095-4344.2015.53.006

Abstract

Abstract:

BACKGROUND: The infection after spinal internal fixation was its serious complications. A number of studies have shown that erythrocyte sedimentation rate and C-reactive protein are of great importance in judging infections.

OBJECTIVE: To analyze the trend of change of erythrocyte sedimentation rate and C-reactive protein for patients without infection after the cervical fixation.

METHODS: Totally 56 patients, who underwent cervical fixation from October 2013 to July 2014, were retrospectively analyzed, and then divided into anterior cervical group (n=29) and posterior cervical group (n=27). Patients in the anterior cervical group underwent anterior cervical decompression bone graft internal fixation. Patients in the posterior cervical group underwent posterior cervical unilateral open door decompression internal fixation. The peripheral blood was collected before fixation and at the early morning of the 1, 3, 6, 9 days after fixation. Erythrocyte sedimentation rate and C-reactive protein values were determined. The follow-up of patients was more than one year. Signs of infection did not appear.

RESULTS AND CONCLUSION: (1) General rule: After the cervical fixation, the erythrocyte sedimentation rate

was increased significantly and reached a peak on postoperative day 6. The peak level gradually decreased but has not returned to normal at the 9 postoperative days. The C-reactive protein increased significantly on the first postoperative day and reached a peak on postoperative day 3. The peak level rapidly decreased but has not returned to normal at the 9 postoperative days. The level of erythrocyte sedimentation rate of patients in the posterior cervical group was significantly higher than that in the anterior cervical group at 3, 6 and 9 days after internal fixation (P < 0.05). There was no significant difference in the C-reactive protein between these two groups (P > 0.05). (2) These results demonstrate that C-reactive protein is an important indicator of monitoring the inflammatory response of patients after cervical internal fixation, which was conductive to the judgment of early infection after internal fixation. The abnormal inflammatory indices of erythrocyte sedimentation rate and C-reactive protein do not suggest a presence of blade infection after internal fixation. C-reactive protein can reach the peak at 3 days after fixation. It is recommended to check blood at 2 and 3 days. If there is no apparent rebound, then the possibility of infection is small. It may indicate the presence of infection if the inflammatory indices increased again or decreased slowly after the decrease.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

CLC Number:

R318

Liang Chen, Sun Jian-min, Cui Xin-gang, Jiang Zhen-song, Li Tao. The trend of change and clinical significance of early-phase inflammatory indices after cervical fixation [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(53): 8560-8566.

Figures/Tables 8

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