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.
METHODS
Prospective study.


OBJECTIVE
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).


BACKGROUND
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.
Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.
Chae-Gwan
CG
Kong
Young-Yul
YY
Kim
Chi Young
CY
Ahn
Jong-Beom
JB
Park
Absolute neutrophil count; Allograft; Anterior cervical discectomy and fusion; Demineralized bone matrix; White blood cell