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Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients.

Abstract：

PURPOSE:Interleukin 6 (IL-6) and the acute phase C-reactive protein (CRP) blood concentrations after lumbar spine fusion may be affected by age. The purpose of this prospective observational study was to assess postoperative serum levels of pro-inflammatory IL-6 and CRP after instrumented lumbar spine fusion surgery. We hypothesized that older patients would have increased levels of IL-6 and CRP after surgery. METHODS:IL-6 and high-sensitive CRP biochemical marker levels were measured before instrumented spinal fusion, and postoperatively at 1 and 3 days, 6 weeks, and 3 months. The 49 patients in this sample were divided into two groups: age ≤ 60 years ( n = 23) and age > 60 years ( n = 26). RESULTS:Acute changes in IL-6 high-sensitivity and CRP from preoperative levels to postoperative day (POD) 1 increased with age. Mean (95% CI) difference between the age-groups in changes of IL-6 at PODs 1 and 3 was 45 pg/ml (10-83, p = 0.014) and 20 pg/ml (5-36, p = 0.021), respectively. Mean (95% CI) difference between groups in changes of CRP at PODs 1 and 3 was 9.6 mg/l (-3.5 to 22.7, p = 0.47) and 24.8 mg/l (-17 to 67, p = 0.33), respectively. Both groups had decreased IL-6 and CRP levels at 6 weeks after surgery compared to the preoperative level. CONCLUSIONS:Elevation of IL-6 and CRP is stronger in patients over 60 years old after instrumented lumbar spinal fusion. The CRP and IL-6 are sensitive markers for acute postoperative inflammation. Even high acute CRP values do not necessarily indicate postoperative infection.

journal_name

J Orthop Surg (Hong Kong)

journal_title

Journal of orthopaedic surgery (Hong Kong)

authors

Repo JP,Häkkinen AH,Porkka T,Häkkinen K,Kautiainen H,Kyrölä K,Neva MH

doi

10.1177/2309499019826406

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

2309499019826406

issue

1

eissn

1022-5536

issn

2309-4990

journal_volume

27

pub_type

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