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

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http://hdl.handle.net/10138/300015

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Repo , J P , Häkkinen , A H , Porkka , T , Häkkinen , K , Kautiainen , H , Kyrölä , K & Neva , M H 2019 , ' Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients ' , Journal of Orthopaedic Surgery , vol. 27 , no. 1 , 2309499019826406 . https://doi.org/10.1177/2309499019826406

Title: Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients
Author: Repo, Jussi P.; Häkkinen, Arja H.; Porkka, Tuukka; Häkkinen, Keijo; Kautiainen, Hannu; Kyrölä, Kati; Neva, Marko H.
Contributor: University of Helsinki, Clinicum
Date: 2019-01-31
Language: eng
Number of pages: 6
Belongs to series: Journal of Orthopaedic Surgery
ISSN: 2309-4990
URI: http://hdl.handle.net/10138/300015
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 = 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.
Subject: C-reactive protein
fusion
interleukin-6
lumbar
spine
surgery
INFLAMMATION
DISABILITY
RECOVERY
DISEASE
QUALITY
MARKERS
INJURY
AGE
3126 Surgery, anesthesiology, intensive care, radiology
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