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Patient temperature
2%
19/1174
WBC count
3%
30/1174
Erythrocyte sedimentation rate
7%
87/1174
C-reactive protein
87%
1027/1174
Rheumatoid Factor
0%
5/1174
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The most sensitive parameter to detect inflammation elicited by implants and infection is the C-reactive protein (CRP). CRP is an acute phase reactant that increases sharply immediately after surgery within 6 hours after tissue damage. CRP then peaks 2-3 days later and returns to normal levels 5-21 days after the inciting event. In contrast, ESR reaches its peak on days 4-11, then remains elevated for a prolonged period of time. Takahashi et al performed a Level 3 study of patients who had undergone spinal surgery with and without instrumentation, with a primary outcome of infection. They concluded that renewed elevation of C-reactive protein, white blood cell count, and body temperature after postoperative days 4 to 7 may be a key indicator of postoperative infection.
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