Volume 4 | Issue 1 | Jan – June 2019 | Page 10-15 | Ross B. Ingber
Authors : Ross B. Ingber [1]
[1] Northwell Health, Department of Radiology, Manhasset, New York
Address of Correspondence
Dr. Ross B. Ingber,
Northwell Health, 300 Community Drive Manhasset, NY 11030
Email: ross.b.ingber@gmail.com
Abstract
Background: Early post-operative spinal infection (EPSI) is a potentially catastrophic complicationfollowing spinal surgeries.Although critically important, diagnosing spinal infections in the early post-operative period is challenging due to anelevation of serologicmarkers causedby invasive surgery.The purpose of thestudy is to find the indicators in bloodtest results to aid in thedifferentiation of EPSI.
Methods: Studies were systematicallyevaluated thePubMed, Embase, and Ovid peer-reviewed librarydatabases to assess all studiesthrough July 2015. The studies reviewed discussed erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count in both infected and noninfected patients following orthopedic surgery. The literature was heterogeneous; however, areview of the articles illustrated the importance of serologic markers in diagnosing post-operative infection.
Results: There was a marked difference between the type of surgical procedures and timing for diagnosis in the studies evaluating WBC count, ESR, and CRP levels for the diagnosis of spinal infections.Furthermore, the sensitivity and specificity varied in the different procedures, timing for diagnosis, and cutoff value pointswithin each serologicmarker. However,thesecond peakin ESR and CRP levels could be utilized as an indicatorwhen attempting to diagnose an infection.
Conclusions: Based on this systematic review, it is difficult to recommend a specific marker or a specific level to determine EPSI. However, a combination of these markers in adjunction with clinical examination and imaging studies may aid in determiningEPSI.Studies are necessary to investigate the serologicmarkers based on the specific days after surgery and the size of spinal surgery. Finally, blood test results may be just supplemental information for the determination of EPSI.
Keywords: C-reactive protein, erythrocyte sedimentation rate, white blood cell count, post-operative infection, acute spine infection.
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How to Cite this Article: Ingber R B. Diagnosing Early Post-operative Spinal Infection – A Systematic Review. International Journal of Spine Jan-June 2019;4(1):10-15.
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