Abstract: OBJECTIVE To investigate the risk factors of infection in patients with spinal disease after surgery and its relationship with the levels of serum procalcitonin（PCT）, soluble leukocyte differentiation antigen subtype 14（Presepsin） and erythrocyte sedimentation rate（ESR） sedimentation. METHODS A total of 287 patients with spinal disease who were treated in Hainan Zhongde Orthopedic Hospital between Jan. 2017 and Dec. 2019 were recruited. They were divided into the infection group（n=26） and uninfected group（n=261） according to whether or not patients had postoperative infection. The clinical data of the two groups were retrospectively analyzed, the levels of serum PCT, Presepsin and ESR were compared between the two groups before and 1 day after surgery; multivariate logistic regression analysis was performed to find outthe factors affecting the incidence of infection in patients with spinal disease after surgery. RESULTS One day after the operation, the levels of serum PCT, Presepsin, and ESR in the infected group were significantly higher than that in the uninfected group（P＜0.05）. Multivariate Logistic regression analysis showed that age＞60 years, diabetes, operation time≥3 hours, internal fixation, and high levels of PCT, Presepsin, and ESR were risk factors of infections after surgery（P＜0.05）. CONCLUSION Serum PCT, serum Presepsin and ESR are highly expressed in patients with postoperative spinal disease infection, and age＞60 years, diabetes, operation time≥3 h, internal fixation, and high levels of PCT, Presepsin and ESR are independent risk factors of infections after spinal disease surgery. Clinical attention should be given to prevent infections in patients with spinal disease.