J Korean Soc Spine Surg.  2003 Jun;10(2):97-103. 10.4184/jkss.2003.10.2.97.

Changes of ESR, CSR and CRP after Posterior Decompression and Posterolateral Fusion of the Lumbar Stenosis

• An KC
• Lee CS
• Choi JY

• KMID: 2003206
• DOI: http://doi.org/10.4184/jkss.2003.10.2.97

Abstract

PURPOSE
To help in the early diagnosis of postoperative infections in lumbar stenosis, attempts were made to evaluate a large number of patients having levels of ESR, CSR and CRP at fixed intervals, following an uncomplicated instrumented posterolateral fusion with wide decompression.
MATERIALS AND METHODS
101 lumbar stenosis patients were included in this study. The levels of ESR, CSR and CRP were checked on the 2nd, 3rd, 4th, 7th, 10th and 14th postoperative days. These data were plotted in relation to time in order to follow their changes. The relationships between these and the perioperative factors (operation time, fusion levels, estimated bleeding amount and transfusion amount) were evaluated statistically.
RESULTS
The ESR and CSR had peak levels by the 3rd postoperative day, which then became highly variable until 14 days. The CRP level was highest on the 2nd postoperative day, which decreased rapidly, was and reached nearly normalized levels by 14th day. The ESR and CSR values on the 7th postoperative day showed a tendency to correlate with the perioperative factors, but the CRP value showed no significant correlations.
CONCLUSIONS
Our study revealed the effectiveness of CRP, and ineffectiveness of ESR and CSR, in the early detection of deep infections following surgery for wide lumbar stenosis.

Keyword

Lumbar spinal stenosis; wide decompression; ESR; CSR; CRP

MeSH Terms

Constriction, Pathologic*
Decompression*
Early Diagnosis
Hemorrhage
Humans

Figure

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  Fig. 1. This chart shows the calculating method of CSR using ESR by adjustment of hematocrit and sex. The CSR level of a man having 35mm/hr ESR, 40% hematocit is 25mm/hr by this chart.(ref. Wintrobe MM and Landsberg JW: A standardized technique for the blood sedimentation test. J Lab and Clin Med, 19(777): 102-115,1934.)

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  Fig. 2. Change of average ESR value in non-infected 101 cases. The elevated value of 3rd day was not decreased till postoperative 14th day.

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  Fig. 3. Change of average CSR value in non-infected 101 cases. The elevated value of 3rd day was not decreased till postoperative 14th day.

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  Fig. 4. Change of average CRP value in non-infected 101 cases. The value was peak on postoperative 2nd day and decreased rapidly to near normal value on 14th day.

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  Fig. 5. The serial ESR plottings of infected 4 cases. The ESR value of non-infected with 1 standard deviation (grayish area) was not effective in early detection of deep infections.

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  Fig. 6. The serial CRP plottings of infected 4 cases. There were abrupt re-elevations on 7th day (3 cases) or 10th day (1 case). The CRP value of non-infected was effective in early detection of deep postoperative infection. The gray colored area means CRP value of non-infected cases with 1 standard deviation.

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