Fever Is Common Postoperatively Following Posterior Spinal Fusion: Infection Is an Uncommon Cause

作者:Blumstein Gideon W; Andras Lindsay M; Seehausen Derek A; Harris Liam; Ross Patrick A; Skaggs David L*
来源:Journal of Pediatrics, 2015, 166(3): 751-755.
DOI:10.1016/j.jpeds.2014.11.033

摘要

Objective To determine the frequency and clinical significance of postoperative fever in pediatric patients undergoing posterior spinal fusion (PSF). Study design A retrospective chart review was performed for consecutive patients undergoing PSF at a single institution between June 2005 and April 2011, with a minimum of 2-year follow up. Exclusion criteria were previous spine surgery, a combined anterior-posterior approach, and delayed wound closure at the time of surgery. Results Two hundred and seventy-eight patients with an average age of 13 years (1-22 years) met inclusion criteria, with the following diagnoses: adolescent idiopathic scoliosis 43%, neuromuscular/syndromic scoliosis 39%, congenital scoliosis 11%, spondylolisthesis 4%, and Scheuermann kyphosis 3%. Seventy-two percent (201/278) of patients had a maximum temperature (T-max) > 38 degrees postoperatively, and 9% (27/278) T-max > 39 degrees. The percentage of febrile patients trended down following the first postoperative day. Infection rate was 4% (12/278). There was no correlation between T-max > 38 degrees or T-max > 39 degrees, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Conclusion Seventy-two percent of pediatric patients undergoing PSF experienced postoperative fever, and 9% of patients had T-max > 39 degrees. There was no significant correlation between fever and positive blood culture, urine culture, pneumonia, or surgical site infection. This information may help relieve stress for families and healthcare providers, and obviate routine laboratory evaluation for fever alone.

  • 出版日期2015-3