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Actin-free Gc-globulin after minimal access and conventional anterior lumbar surgery
Tsung-Jen Huang1, Yi-Jan Weng, Yen-Yao Li
1Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia-Yi, College of Medicine, Chang Gung University, Taipei, Taiwan. tjhuang@adm.cgmh.org.tw
Background:
Minimally invasive total knee or hip replacement has been increasingly adopted in recent years. However, literature indicates that minimally invasive joint arthroplasty may not always reduce pain or tissue trauma. We hypothesized that the tissue damage would be reduced in minimal access surgery (MAS) than the conventional open surgery (OS) for anterior lumbar disorders through quantifying measurement of serum actin-free Gc-globulin (Af-Gc), myoglobin (MG), and total creatine kinase (CK).
Materials And Methods:
This prospective study enrolled 23 patients, including 10 who underwent MAS and thirteen who underwent conventional OS. Blood samples for Af-Gc, MG, and CK were taken simultaneously before surgery and then at intervals of 12, 24, 48, 72, 120, and 168 h thereafter.
Results:
All serum level changes in Af-Gc, MG, and CK were significantly lower in the MAS than in the OS group. A significant negative correlation was noted between changes in Af-Gc and MG levels (P = 0.012), and a significant positive correlation was noted between changes in CK and MG levels (P < 0.001). However, at 12 h postop, CK level was transiently higher in MAS group than the OS group.
Conclusions:
The changes of Af-Gc, MG, and CK levels indicate that MAS is less tissue invasive than OS. Further, Af-Gc proved to be a more sensitive marker than MG or CK in response to surgical trauma. The transiently higher CK level at 12 h postop in MAS patients may indicate that a more soft tissue manipulation is required in MAS than the OS patients for the initial surgical approach.
Insights
Minimal access surgery (MAS) showed reduced tissue trauma compared to open surgery (OS) in anterior lumbar disorders, as indicated by lower serum levels of actin-free Gc-globulin (Af-Gc), myoglobin (MG), and creatine kinase (CK). Af-Gc emerged as a sensitive marker for surgical trauma.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
- Biomarker Analysis
Background:
- Minimally invasive joint arthroplasty adoption is rising, but its effectiveness in reducing pain and trauma is debated.
- Previous literature suggests potential limitations in pain reduction and tissue trauma with minimally invasive joint procedures.
- This study investigates tissue damage in minimal access surgery (MAS) versus conventional open surgery (OS) for anterior lumbar disorders.
Purpose of the Study:
- To quantify and compare tissue damage between MAS and OS for anterior lumbar disorders.
- To evaluate serum levels of actin-free Gc-globulin (Af-Gc), myoglobin (MG), and total creatine kinase (CK) as indicators of tissue trauma.
- To determine the sensitivity of Af-Gc, MG, and CK as biomarkers for surgical trauma.
Main Methods:
- Prospective study involving 23 patients undergoing either MAS (n=10) or OS (n=13) for anterior lumbar disorders.
- Blood samples collected pre-surgery and at multiple intervals post-surgery (12, 24, 48, 72, 120, 168 hours).
- Analysis of serum levels of actin-free Gc-globulin (Af-Gc), myoglobin (MG), and total creatine kinase (CK).
Main Results:
- Serum level changes of Af-Gc, MG, and CK were significantly lower in the MAS group compared to the OS group.
- Significant negative correlation between Af-Gc and MG changes (P=0.012); significant positive correlation between CK and MG changes (P<0.001).
- A transient increase in CK levels was observed in the MAS group at 12 hours post-operation compared to the OS group.
Conclusions:
- Serum level changes of Af-Gc, MG, and CK indicate that MAS is less tissue invasive than OS for anterior lumbar disorders.
- Actin-free Gc-globulin (Af-Gc) demonstrated higher sensitivity as a biomarker for surgical trauma compared to MG and CK.
- Transiently elevated CK levels in MAS at 12 hours may suggest increased soft tissue manipulation during the initial surgical approach.
