Abstract
Objective: To highlight the pattern of changes of the biomarkers like Leukocytes, ESR and C-reactive protein (CRP) in the postoperative period of lumbar discectomy and its significance in the early diagnosis of postoperative discitis after lumbar discectomy.
Methodology: This prospective study was performed from October 2013 to November 2015 with a total of 287 patients underwent lumbar intervertebral discectomy surgery in Basrah Teaching Hospital and Ibn Al-Bitar private hospital, Basrah. Patients with previous spine surgery, spine infection, recent systemic infection, and debilitating diseases were excluded. Preoperatively, Leukocytes, ESR and CRP were measured on the day before surgery and at second, fifth and seventh postoperative days (POD).
Results: Most of the patients had single disc prolapse, and most operated levels were L4-L5 and L5-S1. Two level discectomies were done for only 19 patients. The surgical procedures were fenestration in 72 patients, hemi laminectomy in 17, and 198 had full laminectomy. Postoperatively, only 13(4.5%) patients developed discitis and thus need further evaluation to exclude infection. In symptomatic patients, there are no local signs of inflammation at the operation site and only two patients presented with fever.
Conclusion: CRP tests at least once preop, and at POD3 and POD5 was predictable and responsive serum biomarker in postoperative monitoring of inflammatory responses in patients undergoing spine surgery, whereas leukocytes count was unspecific.

Key words: Disc prolapse, discitis, postoperative complication, biomarkers, leukocytes, erythrocyte sedimentation Rrate (ESR), C-reactive protein (CRP).