Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients
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 sp...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-01-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/2309499019826406 |
| _version_ | 1818495739486011392 |
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| author | Jussi P Repo Arja H Häkkinen Tuukka Porkka Keijo Häkkinen Hannu Kautiainen Kati Kyrölä Marko H Neva |
| author_facet | Jussi P Repo Arja H Häkkinen Tuukka Porkka Keijo Häkkinen Hannu Kautiainen Kati Kyrölä Marko H Neva |
| author_sort | Jussi P Repo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T18:24:44Z |
| format | Article |
| id | doaj.art-6365b54a97f64437a2c9ba01cec3e33a |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-10T18:24:44Z |
| publishDate | 2019-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-6365b54a97f64437a2c9ba01cec3e33a2022-12-22T01:38:07ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902019-01-012710.1177/2309499019826406Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patientsJussi P Repo0Arja H Häkkinen1Tuukka Porkka2Keijo Häkkinen3Hannu Kautiainen4Kati Kyrölä5Marko H Neva6 Department of Surgery, Central Finland Health Care District, Jyväskylä, Finland Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland Biology of Physical activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland Department of General Practice, University of Helsinki and Helsinki University Hospital, HUS, Finland Department of Surgery, Central Finland Health Care District, Jyväskylä, Finland Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, FinlandPurpose: 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.https://doi.org/10.1177/2309499019826406 |
| spellingShingle | Jussi P Repo Arja H Häkkinen Tuukka Porkka Keijo Häkkinen Hannu Kautiainen Kati Kyrölä Marko H Neva Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients Journal of Orthopaedic Surgery |
| title | Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients |
| title_full | Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients |
| title_fullStr | Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients |
| title_full_unstemmed | Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients |
| title_short | Increased interleukin-6 and C-reactive protein levels after instrumented lumbar spine fusion in older patients |
| title_sort | increased interleukin 6 and c reactive protein levels after instrumented lumbar spine fusion in older patients |
| url | https://doi.org/10.1177/2309499019826406 |
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