Quantitation of C-reactive protein levels and erythrocyte sedimentation rate after spinal surgery.

C-reactive protein and erythrocyte sedimentation rate were prospectively measured after four types of uncomplicated spinal operations. In all patients, preoperative normal C-reactive protein (less than 10 mg/L) increased, reaching peak levels on the second day after microdiscectomy (46 +/- 21 mg/L) and anterior fusion (70 +/- 23 mg/L), and at the third day after conventional discectomy (92 +/- 47 mg/L) and posterolateral intercorporal fusion (173 +/- 39 mg/L), with normalization in 5-14 days. Peak levels were not related to bleeding, transfusion, operation time, administered drugs, age, or sex. Erythrocyte sedimentation rate increased to peak levels about 5 days after surgery, followed by a slow and irregular decrease, and at 21-42 days after surgery often remained elevated. The rapid decline in C-reactive protein will probably be interrupted by a second rise or persisting elevation if infection occurs. C-reactive protein is presumably a better test than erythrocyte sedimentation rate for early detection of postoperative infection.