Abstract | PURPOSE:
C-reactive protein (CRP) and white blood cell (WBC) count are routine blood chemistry parameters in monitoring infection. Little is known about the natural history of their serum levels in conservative and operative spondylodiscitis treatment. METHODS: RESULTS: Surgery had a significant effect on peak postoperative CRP levels. In surgically managed patients, CRP peaked at 2-3 days after surgery ( spondylodiscitis: pre-OP: 90 mg/dl vs. post-OP days 2-3: 146 mg/dl; DDD: 9 mg/dl vs. 141 mg/dl; p < 0.001), followed by a sharp decline. Although values were higher for spondylodiscitis patients, dynamics of CRP values were similar in both groups. Nonoperative treatment showed a slower decline. Surgically managed spondylodiscitis showed a higher success rate in identifying bacteria. Specific antibiotic treatment led to a more predictable decline of CRP values. WBC did not show an interpretable profile. CONCLUSION: CRP is a predictable serum parameter in patients with spondylodiscitis. WBC count is unspecific. Initial CRP increase after surgery is of little value in monitoring infection. A preoperative CRP value, and control once during the first 3 days after surgery is sufficient. Closer monitoring should then be continued. Should a decline not be observed, therapy needs to be scrutinized, antibiotic treatment reassessed, and concomitant infection contemplated.
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Authors | Christina van Gerven, Kevin Eid, Tobias Krüger, Michael Fell, Daniel Kendoff, Michael Friedrich, Clayton N Kraft |
Journal | Journal of orthopaedic surgery (Hong Kong)
(J Orthop Surg (Hong Kong))
2021 Jan-Apr
Vol. 29
Issue 1
Pg. 2309499020968296
ISSN: 2309-4990 [Electronic] England |
PMID | 33377405
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- C-Reactive Protein
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(therapeutic use)
- C-Reactive Protein
(analysis)
- Discitis
(blood, drug therapy, microbiology, surgery)
- Female
- Humans
- Leukocyte Count
- Male
- Middle Aged
- Retrospective Studies
- Spinal Fusion
(methods)
- Young Adult
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