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Korean J Spine > Volume 4(3); 2007 > Article
11
Early Phase Inflammatory Markers after Spinal Block Procedures
Yang Moon Seok, M.D., Byung Kwan Choi, M.D., Lee Sang Won, M.D., Cha Seung Heon, M.D., Song Geun Sung, M.D., Choi Chang Hwa, M.D.
Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
Early Phase Inflammatory Markers after Spinal Block Procedures
Yang Moon Seok, M.D., Byung Kwan Choi, M.D., Lee Sang Won, M.D., Cha Seung Heon, M.D., Song Geun Sung, M.D., Choi Chang Hwa, M.D.
Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
Abstract
Objective: This study is designed to evaluate of the early changes of hematologic parameters such as erythrocyte sedimen- tation rate(ESR), C-reactive protein(CRP) and white blood cell(WBC) for diagnosis of early infection after spinal block pro- cedures in patients without clinical signs of infection.
Methods: This study included 60 consecutive patients who underwent spinal block procedures between January 2005 and December 2006. We analyzed the ESR, CRP, WBC count before procedure and on first week, third week and fourth week after procedure. The subject include 45 cases selective nerve root block, 4 cases medial branch block and 11 cases facet joint block. The procedures were performed in the cervical and lumbosacral spine.
Results: The ESR was abnormal value in 14 pateints(23.3%), whereas CRP and WBC values were normal value in all patients before block procedures. The ESR or CRP levels increased in 98.3% after the procedure compared with prepro- cedures. The ESR and CRP levels after procedure showed abnormal increased range in 63.3, 83.3% of patients in consecutive laboratory variables. All elevated values returned to the range of preprocedure by 30 days after procedure. All patients except 3 patients remained in normal range after procedure for 30 days. The decline of ESR was more slow compared with the CRP. For all patients, there were no clinical conditions suspecting active inflammation.
Conclusion: It is necessary to understand the changing patterns of inflammatory indexes in the early postprocedural phase. Inflammatory parameters such as ESR, CRP and WBC after procedure should be interpreted with caution because these parameters frequently could be revealed in abnormal range after block procedure.
Keywords: Erythrocyte sedimentation rateㆍC-reactive proteinㆍWhite blood cell countㆍSpinal block procedureㆍInflammatory reaction


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