| Features of Postoperative Spinal Infections in Elderly Patients |
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Young-Jin Park , Tae-Wan Kim , Kwan-Ho Park, Moon-Pyo Chi , Jung-Chul Kim |
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Department of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea |
| 노년층에서 발생한 척추 수술 후 감염의 양상 |
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| Abstract |
Objective
Postoperative infection remains a troublesome but not uncommon complication after spinal surgery.
Infection places the patient at risk for poor outcome including pseudoarthritis, prolonged pain, adverse neurologic
sequelae, and even death. The purpose of this study was to evaluate the features of postoperative infections in elderly
patients to provide a guideline to prevent such unwanted events.
Methods
We operated lumbar surgery to 459 patients between January 2006 to December 2007. Of these, an analysis
was carried out retrospectively with 21 patients who deveoloped postoperative infections (discitis and osteomyelitis).
We excluded 1 infectious patient whose preoperative C reactive protein (CRP) was above normal range. We compared
the clinical, laboratory (CRP and Erythrocyte Sedimentation Rate, ESR) and radiological results between two groups,
more 65 years of age and those below 65.
Results
There were no specific differences on clinical features between two groups. All patients complained recurrent
back pain. The changes of CRP and ESR showed similar pattern on postoperative 2nd day, 1st week, and 2nd weeks
in instrumented patients. The differences of changes of ESR and CRP were shown on non-instrumented groups,
but had limitation because of too small population. The destruction of vertebral body was worse on old age group
than the other group especially in cases with those requiring the removal of devices.
Conclusion
Although this study consisted of small population, the CRP showed a peak on second postoperative
day and the elevation of ESR was more gradual on old-aged groups when instrumentation was not applied. The
destruction of vertebral body was worse on old age group than the other group especially in case where device
was removed. Therefore, the removal of device should be considered more carefully in old-aged group. |
| Key Words:
Postoperative infection⋅ESR⋅CRP⋅Destruction⋅Old age |
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