Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
Keck School of Medicine, University of Southern California, Los Angeles, CA.
J Pediatr. 2015 Mar;166(3):751-5. doi: 10.1016/j.jpeds.2014.11.033. Epub 2015 Jan 6.
To determine the frequency and clinical significance of postoperative fever in pediatric patients undergoing posterior spinal fusion (PSF).
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.
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 (Tmax) >38(°) postoperatively, and 9% (27/278) Tmax >39(°). The percentage of febrile patients trended down following the first postoperative day. Infection rate was 4% (12/278). There was no correlation between Tmax >38(°) or Tmax >39(°), and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection.
Seventy-two percent of pediatric patients undergoing PSF experienced postoperative fever, and 9% of patients had Tmax>39(°). 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.
确定行后路脊柱融合术（PSF）的小儿患者术后发热的频率及临床意义。
对 2005 年 6 月至 2011 年 4 月在单家机构行 PSF 的连续患者进行回顾性图表审查，随访时间至少 2 年。排除标准为先前脊柱手术、前后联合入路以及手术时延迟伤口闭合。
278 例平均年龄为 13 岁（1-22 岁）的患者符合纳入标准，诊断如下：青少年特发性脊柱侧凸 43%、神经肌肉/综合征性脊柱侧凸 39%、先天性脊柱侧凸 11%、脊椎滑脱 4%和Scheuermann 后凸 3%。72%（201/278）的患者术后最高体温（Tmax）>38°C，9%（27/278）的 Tmax >39°C。术后第一天，发热患者的比例呈下降趋势。感染率为 4%（12/278）。Tmax >38°C或 Tmax >39°C 与发热时间、血或尿培养阳性、肺炎或手术部位感染之间无相关性。
72%行 PSF 的小儿患者出现术后发热，9%的患者 Tmax >39°C。发热与血培养阳性、尿培养阳性、肺炎或手术部位感染之间无显著相关性。这些信息可能有助于减轻家属和医疗保健提供者的压力，并避免单纯因发热而进行常规实验室评估。
