356 - The Relationship between Pre-op ESR and CRP Level and Spine Surgery In...

#356 The Relationship between Pre-op ESR and CRP Level and Spine Surgery Infections

General Session: Infections/Tumor

Presented by: T. Morrison

Author(s):

T. Morrison (1)
X. Hu (2)
I.H. Lieberman (2)

(1) Parkview Orthopaedic Clinic, Citizens Memorial Hospital, Brighton, MO, USA
(2) Texas Back Institute, Texas Health Presbyterian Hospital Plano, Scoliosis and Spine Tumor Center, Plano, TX, USA

Abstract

Introduction: Preoperative Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are commonly used to evaluate the presence of infection before or after spine surgery. However, it is still not clear if there is a relationship between preoperative ESR and CRP levels and postoperative infections. The aim of this study is to review a series of spine surgeries and to evaluate the relationship between preoperative ESR and CRP levels and postoperative infections.

Methods: Data were retrospectively collected from medical charts and surgical reports following each surgery. All surgeries were performed at the same hospital by a single surgeon. The majority of patients underwent degenerative and/or adolescent scoliosis, kyphosis, spinal stenosis, spondylolisthesis, and or complex revision surgery. The patients were classified into two different groups based on preoperative ESR and CRP levels: patients who had normal pre-op ESR and CRP levels (group 1) and patients who had high pre-op ESR and/or CRP levels (group 2).

Results: A total of 200 surgeries (193 patients) were included in this study between April 2010 and December 2011. Seventy four percent of the patients had spinal deformity and/or previous spine surgeries. There were 107 surgeries (104 patients) with normal preoperative ESR and CRP levels (group 1). The patients' median age is 50 years old and their mean BMI is 25.7. There were 93 cases (89 patients) with high preoperative ESR and/or CRP levels (group 2). The patients' median age is 59 years old and their mean BMI is 27.6. There was one infected case in group 1 (0.93%, deep wound infection, happened at four weeks post-op) and four infected cases in group 2 (4.30%, all deep wound infections, happened between one and four weeks post-op). The infection rate between these two groups is not statistically different (p>0.05). Details of the five infected cases were shown in table 1.

Conclusions: The patients with high preoperative ESR and CRP levels seem to have relatively higher infection rate but the difference is not significant. This preliminary data suggests that the preoperative ESR and CRP levels alone may not be ideal in evaluating the risk of infection in spine surgeries.

Table 1