Postoperative Fever Evaluation Following Lumbar Fusion Procedures

Mayo, Benjamin C.; Haws, Brittany E.; Bohl, Daniel D.; Louie, Philip K.; Hijji, Fady Y.; Narain, Ankur S.; Massel, Dustin H.; Khechen, Benjamin; Singh, Kern

doi:10.14245/ns.1836026.013

Cited by 13 publications

(26 citation statements)

References 36 publications

(34 reference statements)

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“…Fortunately, almost all the patients' temperatures gradually became normal after observation or antipyretic treatments before discharge. Similar to the reports of many previous studies, the evaluation of fever was costly, time consuming, and painful for patients and could add medical expenditure, prolong the hospital stay and waste health care resources [3,4,[8][9][10].…”

Section: Introductionmentioning

confidence: 62%

“…Degenerative lumbar diseases are becoming increasingly common in the aging population, and the number of patients requiring surgery continues to increase [1]. Drainage tubes are widely used at the conclusion of spine surgery to prevent the hematoma formation, compression of the cauda equina nerves, severe neurological dysfunction and fever [2][3][4]. However, in our clinical work, many inpatients encountered a fever in the rst 24 hours after the drainage tube was removed, and the percentage was approximately 40%.…”

Section: Introductionmentioning

confidence: 80%

“…To the best of our knowledge, no previous research has focused on fever after the removal of drainage tubes. However, we found that many studies paid attention to early postoperative fever and suggested that the main reason for postoperative fever was the in ammatory response due to tissue trauma during surgery [4,8,9,11].…”

Section: Introductionmentioning

confidence: 99%

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A Randomized Study on The Prophylactic Use of Acetaminophen to Prevent Fever After The Removal of Drainage Tubes in Lumbar Surgery

Yang

Xing

et al. 2021

Preprint

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Study design: a prospectively random clinical trialObjective: To explore the efficacy of prophylactic use of Acetaminophen in preventing fever after the removal of tube drainage in lumbar surgery.Summary and background data: Many inpatients encountered a fever in the first 24 hours when the drainage tube was removed. When fevers appeared, it was costly to exclude the possibility of deep infection and always failed to identify the etiology. Just like the postoperative fever, we suggested that the fever was caused by the normal inflammatory response, and tried to figure out whether the prophylactic use of Acetaminophen could lower the possibility of fever or not.Methods: 183 consecutive patients undergoing lumbar spine surgery were prospectively randomized into 2 groups. 91 patients were allocated into the study group, they would receive a pill of Acetaminophen (Tylenol, 650mg) before the removal of lumbar tube drainage, and another one at 8p.m. The rest 92 patients were divided into the control group, they were treated in routine treatment without Acetaminophen. In the first 24 hours, a temperature higher than 37.7°C was defined as fever. The 2 groups were then compared for differences in age, gender, height, weight, body mass index (BMI), surgical segments, surgical time, blood loss, blood transfusion, American Society of Anesthesiologists (ASA) score, duration of the tube drainage, total volume of the drainage collection, variation of the levels of WBC, CRP, hospital stay since the removal of drainage to discharge and the rate of fever.Results: There were no differences in all the basic information of 2 groups, but the fever rate of the 2 groups had significant differences (P=0.006), the fever rate of the study group (14/91, 15.38%) was significant lower than the control group (30/92, 32.61%).Conclusion: Fever after the removal of tube drainage was caused by normal inflammation response, and a small dose of acetaminophen could significantly lower the possibility fever. Trail registration: This trail was registered in the ClinicalTrial.gov PRS on July 13, 2019, and the ID was NCT04042948.

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Section: Introductionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 80%

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A Randomized Study on The Prophylactic Use of Acetaminophen to Prevent Fever After The Removal of Drainage Tubes in Lumbar Surgery

Yang

Xing

et al. 2021

Preprint

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“…Unlike this favorable result, Thalgott et al 32) reported that the pseudarthrosis rate in the DBM group was higher than that in the DBM-less group. Overall, the efficacy of DBM in spinal fusion surgery is still controversial in view of the clinical results of DBM 9,22,25,34) . Therefore, we performed a meta-analysis to determine the effectiveness of DBM in spinal fusion surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

Han

Park

Lim

et al. 2020

J Korean Neurosurg Soc

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The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.

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“…Immediate postoperative fevers are generally self-limited, typically resolving within 2 to 3 days, depending on the type and duration of surgery. [73][74][75] Rarely, immediate postoperative fever can be due to malignant hyperthermia. Individuals who are genetically susceptible and exposed to certain anesthetic agents (see Table 5) develop an unregulated influx of calcium leading to persistent muscular contraction.…”

Section: Immediatementioning

confidence: 99%