Articles | Volume 11, issue 4
https://doi.org/10.5194/jbji-11-503-2026
https://doi.org/10.5194/jbji-11-503-2026
Original full-length article
 | 
18 Aug 2026
Original full-length article |  | 18 Aug 2026

Postoperative inflammatory markers and surgical wound infection after elective short-segment lumbar fusion: the importance of surgical context

Jay Chung, Ta'ir Rocker, Regina Golding, Sachin Mehta, Madison McFarland, Arjun Gupta, Xiuyi Yang, Priya Singh, Evan Olsen, Shreya Balusu, Yungtai Lo, Pamela Zuckerman, Jeremy D. Shaw, and Mitchell S. Fourman

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Cited articles

Alavi, S. M. A., Borgonovo, F., Petri, F., Matsuo, T., Gori, A., Shaw, J. D., Tande, A. J., and Berbari, E. F.: Defining postoperative spinal infections: navigating the inconsistencies in diagnostic definitions, J. Bone Joint Infect., 10, 451–457, https://doi.org/10.5194/jbji-10-451-2025, 2025. 
Aono, H., Takenaka, S., Nagamoto, Y., Tobimatsu, H., Yamashita, T., Furuya, M., Ishiguro, H., and Iwasaki, M.: Impact of spinal instrumentation on early postoperative inflammatory markers: a comparative analysis in the same patient cohort with or without instrumentation, World Neurosurg., 196, 123681, https://doi.org/10.1016/j.wneu.2025.123681, 2025. 
Deirmengian, G. K., Zmistowski, B., Jacovides, C., O'Neil, J., and Parvizi, J.: Leukocytosis is common after total hip and knee arthroplasty, Clin. Orthop. Relat. Res., 469, 3031-3036, https://doi.org/10.1007/s11999-011-1887-x, 2011. 
Elsamadicy, A. A., Serrato, P., Sadeghzadeh, S., Dietz, N., Lo, S. L., and Sciubba, D. M.: Implications of surgical infection on surgical and hospital outcomes after spine surgery: a NSQIP study of 410,930 patients, Clin. Neurol. Neurosurg., 245, 108505, https://doi.org/10.1016/j.clineuro.2024.108505, 2024. 
Hwang, C. J., Park, S., Park, J. Y., Cho, J. H., Lee, C. S., and Lee, D. H.: Sustained postoperative fever without evident cause after spine instrumentation as an indicator of surgical site infection, J. Bone Joint Surg. Am., 102, 1434–1444, https://doi.org/10.2106/JBJS.19.01490, 2020. 
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Short summary
After elective short-segment lumbar fusion, inflammatory blood markers measured on the first postoperative day were strongly influenced by patient and operative factors. Day-three white blood cell count and the neutrophil-to-lymphocyte ratio showed exploratory associations with wound-related events, but these weakened after accounting for day-one values. The findings do not establish diagnostic thresholds and require prospective validation.
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