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. 2013 Sep;7(3):173-7.
doi: 10.4184/asj.2013.7.3.173. Epub 2013 Sep 4.

Diagnostic usefulness of white blood cell and absolute neutrophil count for postoperative infection after anterior cervical discectomy and fusion using allograft and demineralized bone matrix

Chae-Gwan Kong  1 , Young-Yul Kim, Chi Young Ahn, Jong-Beom Park
Affiliations

Diagnostic usefulness of white blood cell and absolute neutrophil count for postoperative infection after anterior cervical discectomy and fusion using allograft and demineralized bone matrix

Chae-Gwan Kong et al. Asian Spine J. 2013 Sep.

Abstract

Study design: Prospective study.

Purpose: We investigated normative temporal levels of white blood cell (WBC) and absolute neutrophil count (ANC) in uncomplicated anterior cervical discectomy and fusion (ACDF) using allograft and demineralized bone matrix (DBM).

Overview of literature: No study has investigated the diagnostic usefulness of WBC and ANC for postoperative infection following ACDF using allograft and DBM.

Methods: Blood samples of 85 patients, who underwent one or two-level ACDF, were obtained and evaluated before surgery and on the first, third, fifth, seventh, fourteenth, thirtieth, and ninetieth postoperative days. No infection was found in all patients for at least one year follow-up period.

Results: Mean WBC and ANC values increased significantly and reached peak levels on the first postoperative day. The peaked levels rapidly decreased but still remained elevated above the preoperative levels on the third postoperative day. The levels returned close to the preoperative levels on the fifth postoperative day. The mean WBC and ANC values did not get out of their normal reference ranges throughout the follow-up periods. One-level and two-level ACDF exhibited a similar course of postoperative changes in WBC and ANC values and no significant difference in mean levels of WBC and ANC throughout the follow-up periods.

Conclusions: Uncomplicated ACDF using allograft and DBM showed normal values of WBC and ANC during the early postoperative period. Therefore, significant abnormal values of WBC and ANC at an early postoperative period suggest the possibility of the development of acute postoperative infection after ACDF using allograft and DBM.

Keywords: Absolute neutrophil count; Allograft; Anterior cervical discectomy and fusion; Demineralized bone matrix; White blood cell.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Normal course of postoperative changes for mean white blood cell (WBC) values in uncomplicated anterior cervical discectomy and fusion using allograft and demineralized bone matrix. a)Indicates p<0.01; b)Indicates p <0.05.
Fig. 2
Fig. 2
One-level and two-level anterior cervical discectomy and fusion using allograft and demineralized bone matrix exhibit a similar course of normal postoperative changes for mean white blood cell values throughout the follow-up periods.
Fig. 3
Fig. 3
Normal course of postoperative changes of mean absolute neutrophil count (ANC) values in uncomplicated anterior cervical discectomy and fusion using allograft and demineralized bone matrix. a)Indicates p<0.01; b)Indicates p<0.05.
Fig. 4
Fig. 4
One-level and two-level anterior cervical discectomy and fusion using allograft and demineralized bone matrix exhibit a similar course of normal postoperative changes for mean absolute neutrophil count values throughout the follow-up periods.
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