CRP and leukocyte-count after lumbar spine surgery: fusion vs. nucleotomy

Figures & data

Table 1. General patient characteristics (n = 347), medical history, and comorbidities

General characteristics	Nucleotomy	Fusion surgery	p-value
	(n = 197)	(n = 150)
Age, years	47 (15)	55 (15)	< 0.001
Gender, male	99 (50%)	76 (51%)	1.0
Body weight, kg	79.3 (18)	79.3 (15)	0.9
BMI > 25	39 (20%)	44 (29%)	0.04
Duration of surgery, h	0.86 (0.65)	2.32 (1.16)	< 0.001
Antibiotic treatment
Preoperative administration (24 h)	0 (0%)	4 (2.7%)	0.03
Single-shot intraoperatively	65 (33%)	120 (80%)	< 0.001
Postoperative administration (24 h)	45 (23%)	117 (78%)	< 0.001
Comorbidities and prior surgery
Diabetes mellitus	9 (4.6%)	8 (5.3%)	0.80
Arterial hypertension	24 (12%)	49 (33%)	< 0.001
Coronary heart disease	4 (2.0%)	10 (6.7%)	0.05
History of thrombosis	2 (1.0%)	2 (1.3%)	1.0
History of hip surgery	2 (1.0%)	2 (1.3%)	1.0
History of knee surgery	6 (3.1%)	3 (2.0%)	0.7
History of abdominal surgery	6 (3.1%)	2 (1.3%)	0.5
History of nucleotomy	17 (8.6%)	12 (8.0%)	1.0
ASA classification
I	72 (37%)	21 (14%)	< 0.001
II	21 (11%)	30 (20%)	0.05
III	104 (53%)	98 (65%)	0.02
IV	0 (0%)	1 (0.7%)	< 0.001
V	0 (0%)	0 (0%)	NA

The p-values are means from Chi-square or Fisher's exact tests. Age, body weight, and duration of surgery are given as mean (SD). The p-values are derived from Wilcoxon rank-sum tests. The heterogeneities of sex and obesity were tested with Chi-square tests. NA: Not applicable .

Table 2. Mean profiles of CRP and leukocyte values preoperatively and postoperatively

	Nucleotomy	Fusion surgery	p-value
	(n = 197)	(n = 150)
CRP (mg/L)
Preoperatively	3.0 (3.1)	4.3 (4.6)	< 0.001
Day 1	41 (27)	70 (34)	< 0.001
Day 2–3	75 (48)	127 (58)	0.007
Day 4–6	23 (29)	60 (42)	< 0.001
Day 7–9	13 (19)	29 (34)	< 0.001
Day 10–14	7.1 (9.6)	10 (6.8)	< 0.001
Leukocytes (G/L)
Preoperatively	8.5 (2.9)	7.8 (2.8)	0.02
Day 1	9.3 (3.2)	10.1 (3.0)	0.01
Day 2–3	9.9 (4.4)	9.5 (2.7)	0.6
Day 4–6	7.2 (2.5)	7.3 (2.7)	0.8
Day 7–9	7.3 (2.4)	8.1 (2.7)	0.08
Day 10–14	8.1 (2.5)	8.0 (3.0)	0.6

The inflammatory parameters are summarized as mean (standard deviation). The p-values were derived from Wilcoxon rank-sum tests.

Figure 1. Kinetics of postoperative CRP levels (mg/L): fusion (n = 150) vs. nucleotomy (n = 197). Values are mean and standard deviation.

Figure 2. Kinetics of postoperative white blood cell count (g/L): fusion (n = 150) vs. nucleotomy (n = 197). Values are mean and standard deviation.

Table 3. Multiple regression analysis of peak values of CRP and leukocyte profiles for all patients (n = 347)

	Peak CRP	Peak leukocytes
Multiple regression	0.28	0.62
F-value	23	99
p-value	< 0.001	< 0.001
Intercept
Coefficient (SE)	4.89 (8.6)	1.56 (0.50)
p-value	0.6	0.002
OP procedure
Coefficient (SE)	30 (7.3)	0.35 (0.32)
p-value	< 0.001	0.27
Surgical duration
Coefficient (SE)	5.9 (2.9)	0.50 (0.13)
p-value	0.04	< 0.001
Baseline value
Coefficient (SE)	2.5 (0.7)	0.81 (0.04)
p-value	0.001	< 0.001
Perioperative AB use
Coefficient (SE)	–0.83 (5.7)	0.02 (0.25)
p-value	0.9	0.9
Obesity
Coefficient (SE)	14 (5.9)	–0.06 (0.25)
p-value	0.02	0.8

SE: standard error.

Multifactorial linear regression models were used