Defining the Normal Trends of Serum Creatine Kinase Levels Following Spinal Surgery

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Musculoskeletal Research

Background:

• Spine surgery is a rapidly growing surgical field with potential complications.
• Rhabdomyolysis, indicated by elevated creatine kinase (CK) levels, is a rare but serious complication.
• Limited research exists on CK level changes after spine surgery and the influence of patient positioning.

Purpose of the Study:

• To establish normal creatine kinase (CK) level changes following prone or supine lumbar/cervical spine surgery.
• To investigate whether surgical positioning affects postoperative CK level elevations.

Main Methods:

• Retrospective analysis of 94 patients undergoing spine surgery.
• Measurement of preoperative CK levels and postoperative levels on days 1, 2, 3, and at 2-week follow-up.
• Analysis of CK levels in relation to spine level (lumbar/cervical) and patient positioning (prone/supine).

Main Results:

• Average preoperative CK level was 179.64 IU/L, rising to 847.04 IU/L on postoperative day 1.
• Prone positioning and lumbar procedures resulted in significantly greater CK level increases compared to supine positioning and cervical procedures.
• The combination of prone/lumbar surgery demonstrated the highest CK level increase; revision surgery and instrumentation also elevated postoperative CK levels.

Conclusions:

• Patient positioning influences postoperative creatine kinase (CK) level elevation after spine surgery.
• Prone and lumbar spine surgeries are associated with the most substantial increases in CK levels.
• The observed CK elevation may be attributed to paraspinal muscle damage rather than positioning alone.