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Does Adult Spinal Deformity Affect Cardiac Function? A Prospective Perioperative Study.

Yuki Mihara1,2, Takeji Saitoh3, Tomohiko Hasegawa1

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Adult spinal deformity surgery did not worsen cardiac function. Patients with lower preoperative cardiac function showed significant improvements after surgery, with specific correlations found between cardiac metrics and spinal alignment.

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Area of Science:

  • Cardiology
  • Orthopedic Surgery
  • Spinal Deformity Correction

Background:

  • Adult spinal deformity (ASD) surgery rates are increasing, particularly in older adults.
  • High rates of perioperative complications, including cardiopulmonary issues, persist in ASD surgery.

Purpose of the Study:

  • To investigate perioperative cardiac function in patients undergoing adult spinal deformity surgery.
  • To assess changes in left and right ventricular contractility using echocardiography.
  • To correlate cardiac function with spinopelvic radiographic parameters.

Main Methods:

  • Prospective comparative study of 61 ASD patients (May 2016-April 2018).
  • Echocardiography (preoperative and 2 weeks postoperative) measured LVEF, TAPSE, and S'.
  • Radiographic parameters including thoracic kyphosis, lumbar lordosis, and inflection point were analyzed.

Main Results:

  • Overall cardiac function (LVEF, TAPSE, S') showed no significant change postoperatively.
  • Patients with lower preoperative cardiac function (LVEF<59.3%, TAPSE<17mm, S'<11.8cm/s) demonstrated significant improvements.
  • Lower preoperative inflection point correlated with lower LVEF; larger thoracic kyphosis correlated with lower S'.

Conclusions:

  • Adult spinal deformity surgery does not lead to perioperative cardiac function deterioration.
  • Patients with initially lower cardiac function experience significant postoperative improvements.
  • Preoperative spinal alignment parameters are associated with baseline cardiac function.