title: Peri-operative elastase-alpha-1 proteinase inhibitor in patients with postoperative intervertebral discitis.
abstract: In a prospective study of 251 patients operated upon for lumbar disc herniation it has been investigated whether the preoperative and early postoperative values of Elastase-alpha-1 Proteinase Inhibitor (EPI)-an indicator of inflammatory processes-and C-reactive Protein (CRP)-a well known predictor of some postoperative complications-were correlated to the later development of discitis. Postoperatively discitis developed in 14 patients. A randomly chosen group of 15 complication-free patients out of the total of 251 cases was used as control group. Elevated EPI plasma values, especially in the pre-operative and first postoperative days, turned out to be significantly related to the likelihood of later discitis development, but no such relation for the CRP plasma values could be established. Thus and early prediction of patients at risk for this complication seems to be possible by pre- and postoperative measurement of EPI. It could be justified-but its usefulness has yet to be proven-to give antibiotics prophylactically and other anti-inflammatory medication in patients with elevated pre- and postoperative EPI values.
authors.affiliation: Department of Neurosurgery and Laboratory, (Wagner-Jauregg Medical Centre), Linz, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Huber
authors.forename: C
authors.initials: C
authors.lastname: Kainz
authors.forename: A
authors.initials: A
authors.lastname: Witzmann
authors.forename: H
authors.initials: H
authors.lastname: Beran
authors.forename: J
authors.initials: J
authors.lastname: Fischer
mesh_terms: D000210:Acute-Phase Reaction / Q000175:diagnosis / Q000201:enzymology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D015299:Discitis / Q000175:diagnosis* / Q000201:enzymology; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000201:enzymology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000201:enzymology; D011446:Prospective Studies; D012307:Risk Factors; D015842:Serine Proteinase Inhibitors / Q000097:blood*; D015843:Serpins; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000201:enzymology
chemical_list: D015842:Serine Proteinase Inhibitors; D015843:Serpins; D002097:C-Reactive Protein