Predictive Factors for Muscle Injury After Posterior Lumbar Spinal Surgery

Area of Science:

• Orthopedics
• Neurosurgery
• Sports Medicine

Background:

• Muscle injury, specifically rhabdomyolysis (RML), is a potential complication following posterior lumbar spinal surgery.
• Understanding risk factors and biochemical changes is crucial for patient management and optimizing postoperative care.

Purpose of the Study:

• To identify risk factors for muscle injury in patients undergoing posterior lumbar spinal surgery.
• To evaluate the clearance of postoperative biochemical changes after lumbar fusion.
• To determine optimal timing for monitoring serum levels and their clinical correlation.

Main Methods:

• Prospective enrollment of 39 patients with degenerative lumbar spine disease.
• Analysis of biochemical markers (creatine phosphokinase, creatinine, hemoglobin) at 5 predefined stages.
• Definition of RML as a postoperative 5-fold increase in baseline creatine phosphokinase (CPK).

Main Results:

• Lumbar fusion patients exhibited the highest postoperative CPK ratios.
• The overall incidence of RML was 43.6%.
• Peak CPK and creatinine levels occurred on postoperative day 1 in most patients.
• Independent risk factors for RML included lumbar fusion, surgical duration >270 minutes, and hemoglobin drop >3 g/dL.

Conclusions:

• Prolonged and invasive posterior lumbar spinal surgery with significant bleeding increases RML risk.
• Establishing standardized monitoring intervals for biochemical changes can optimize care and reduce costs.
• The clinical significance of these findings requires further investigation.