| Co-Investigator(Kenkyū-buntansha) |
TAKAOKA Kunio Shinshu Univ., Dept.of Orthopaedic Surgery, Professor and chairman, 医学部, 教授 (30112048)
EBARA Sohei Shinshu Univ., Dept.of Orthopaedic Surgery, Assistant Professor, 医学部, 講師 (40176780)
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| Research Abstract |
1. In thoracic and abdominal surgery, as well as hip arthroplasty, C-reactive protein (CRP) has been proven more valuable than erythrocyte sedimentation rate (ESR) for early detection of postoperative infections complications. It has not yet been established, however, how postoperative inflammatory parameters change when spinal instruments have been inserted into the body. Inflammatory indices, that is, CRP, ESR and body temperature (BT) levels, were significantly higher for the spinal surgery with instruments than those for the spinal surgery without instruments. Multiple regression analysis showed that CRP and ESR peaks significantly correlated with the use of instruments.
2. Post-operative production of pro- and anti-inflammatory cytokines after major surgery has been investigated. Although the level of CRP is presumably a superior indicator for early detection of postoperative infection, it has not yet been established how pro- and antiinflammatory cytokines change post-operatively when spinal instruments have entered the body. Levels of interleukins (IL)-6, 8 and 10, IL-1 receptor antagonist (ra) and soluble tumor necrosis factor (sTNF) receptors (R) 1 and 2 after lumbar spinal posterior decompression and postero-lateral fusion (PLF) with instruments increased significantly compared with those after lumbar spinal posterior decompression and PLF without instruments on days 0 and 1 (p<0.05). Though, seven days after spinal instrumentation surgery, IL-6, 8, 10, and sTNFR1 levels had normalized, IL-1ra and sTNFR2 levels remained elevated. The high rate of infectious complications after spinal instrumentation surgey might be due to prolonged enhancement of anti-inflammatory cytokines.
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