gms | German Medical Science

Objectives: Surgical site infection(SSI) following spine surgery is a critical complication impacting patient recovery. Traditional serum inflammatory markers like C-reactive protein (CRP) and white blood cell count (WBCC) are commonly used to detect SSI. However, the need for earlier diagnostic tools has prompted the exploration of alternative markers. This study investigates the diagnostic potential of platelet count and mean platelet volume ratio as immediate postoperative indicators of SSI, offering a potentially quicker assessment of infection risk than CRP and WBCC.

Methods: In this retrospective study, we analyzed patients who underwent lumbar spine surgery from January 2013 to December 2023. The study comprised 32 patients requiring escalated postoperative care, matched in a 1:3 ratio with 96 control patients based on age, sex, and fusion levels. Parameters measured included CRP, ESR, CRP/albumin ratio, neutrophil to lymphocyte ratio, immature granulocyte count, and platelet count to mean platelet volume ratio, taken immediately after surgery and on POD3. Operation time and estimated blood loss (EBL) were also compared. The study aimed to evaluate the sensitivity, specificity, and likelihood ratios of these biomarkers in predicting SSI.

Results and conclusion: Significant elevations in CRP, ESR, and CRP/albumin ratio were observed on POD3 in patient group, indicating an inflammatory response linked to SSI. Notably, the platelet count to mean platelet volume ratio was the only marker that showed a significant increase immediately post-surgery in the patient group, suggesting its effectiveness as an early infection indicator.

The platelet count to mean platelet volume ratio stands out as a more immediate and effective marker for early detection of SSI following lumbar spine surgery, compared to traditional markers like CRP. This early detection capability could enable quicker clinical interventions, potentially improving patient outcomes and reducing the incidence of postoperative complications. The study highlights the importance of incorporating this platelet index into postoperative monitoring protocols for spine surgery patients.