Are ESR and CRP Acceptable Predictors for Early Post Spinal Surgery Infectious Complication?

Abstract

Introduction ESR and CRP are nonspecific markers of inflammation, used to evaluate post operative infection. CRP is a predictable consisting of a post operative rise and a peak followed by a decrease toward the normal value. Deviation from normal kinematics may be an indication of infection Material and Methods ESR and CRP collected before surgery – 1 – 3 – 7 – 14 – 30 – 45 days post operative in consecutive patients. All infection and abnormal elevation recorded. 60 patients collected with below criteria's (age – sex – etiology – blood loss –Hb – operation time – ESR & CRP before and after operation- temperature – levels of operation - anatomic area and operation approach). Results CRP increased post operative and then decreased slowly during 30 days post operatively, second rise or failure to decrease was not specific in our study. More than 80% of our patients had CRP & ESR elevated more than 30 days without symptoms and signs of infection. We had one superficial. CRP++ or+++ can be for 30 days and ESR more than 20 mm Hg can be 40 days without early post operative infection in spinal surgery. There were correlation between soft tissue damage (long op time – number of levels – combined ASF & PSF) and increased CRP and ESR. ASF alone had no high rise in CRP. In Lumbar PSF operation CRP riser was more than thoracic – cervical or ASF alone. Conclusion ESR and CRP are not predictable factors for early post spinal surgeries infection diagnosis, but specificity and sensitivity of CRP is higher than ESR, when a second rise will be happen.