Limited Diagnostic Utility of Postoperative C-Reactive Protein for Early Detection of Surgical Site Infections Following Posterior Scoliosis Correction Surgery

TL;DR

This study shows that C-reactive protein levels after scoliosis surgery are not reliable for early detection of surgical site infections.

Contribution

The study demonstrates the limited utility of CRP as a diagnostic tool for early surgical site infections after scoliosis correction.

Findings

The overall early surgical site infection rate was 3.91%.

Only 2 out of infected patients showed a rising CRP trend, indicating poor sensitivity.

CRP should not be used alone for diagnosing early infections.

Abstract

Background/Objectives: Surgical site infection (SSI) is a serious complication following scoliosis correction surgery. While CRP monitoring is commonly used after major orthopedic procedures such as joint arthroplasty, its utility for early SSI detection after scoliosis surgery remains unclear. The aim of this study was to evaluate the diagnostic value of postoperative serum C-reactive protein (CRP) concentrations for identifying early surgical site infections (SSI) in patients undergoing scoliosis correction surgery. Methods: A retrospective analysis was performed on a prospectively collected database of 358 patients who underwent posterior spinal fusion for scoliosis between 2014 and 2024 at a single orthopedic center. Patients were divided into idiopathic scoliosis (IS, n = 268) and non-idiopathic scoliosis (N-IS, n = 90) groups. Serum CRP concentrations were measured postoperatively on days 2 and 4 or 3 and 5. The incidence of early SSI and postoperative CRP trends were compared between patients with and without SSI. Results: The overall early SSI rate was 3.91% (IS: 2.24%, N-IS: 8.89%). A clear postoperative decline in CRP was observed in the non-SSI group. In contrast, only 2 patients with confirmed SSI demonstrated a rising CRP trend in the early postoperative period, indicating poor sensitivity of this marker for early infection detection. Conclusions: Postoperative CRP dynamics showed limited diagnostic value for early SSI detection. A rising CRP occurred in only a minority of infected cases. Therefore, CRP should not be used as a standalone marker, and clinical assessment remains essential for early SSI diagnosis.

Figures