Correlation of Inflammatory Markers and Post-Surgical Complications in Spine Surgery: A Multicenter Cohort Study

Abstract

Background: Post-surgical complications following spine surgery remain a significant challenge, with inflammation playing a key role in their development. Identifying inflammatory markers that predict these complications can improve patient management. Objective: To evaluate the correlation between inflammatory markers (CRP, IL-6, TNF-α) and post-surgical complications in spine surgery, including infection, neurological impairment, and thromboembolic events. Methods: This multicenter cohort study was conducted at the Department of Orthopedic Surgery, Rajshahi Medical College Hospital, from January 2021 to June 2023. A total of 162 patients undergoing spine surgery were included. Preoperative levels of CRP, IL-6, and TNF-α were measured and monitored postoperatively to correlate with complications. Statistical analyses, including Pearson’s correlation coefficient, standard deviation (SD), and p-value calculations, were performed. Results: Increased preoperative CRP levels (mean 12.3 mg/L, SD=3.5) were significantly associated with post-surgical infection (p=0.03) and prolonged hospital stay (p=0.02). High IL-6 levels (mean 5.8 pg/mL, SD=1.7) correlated with increased rates of neurological complications, with a 24% higher risk (p=0.04). TNF-α levels showed a significant correlation with thromboembolic events (p=0.01). Overall, 48% of patients with elevated inflammatory markers developed complications, compared to 32% with normal levels, indicating a 16% increased risk for complication development in the elevated marker group. Conclusion: This study highlights the significant role of preoperative inflammatory markers in predicting post-surgical complications in spine surgery. Early identification of these markers can aid in better patient management and improve outcomes.