TY - JOUR
T1 - Serum creatine kinase and lactate dehydrogenase changes after anterior approaches to the thoracic and lumbar spine
AU - Wukich, Dane K.
AU - Van Dam, Bruce E.
AU - Graeber, Geoffrey M.
AU - Martyak, Thomas
PY - 1990/3
Y1 - 1990/3
N2 - Ten patients undergoing anterior approaches to the tho-racic and lumbar spine had prospective determinations of serum creatine kinase, lactate dehydrogenase, and their myocardial-associated isoenzymes (CK-MB and the LD-1/LD-2 ratio). None of these patients experienced postoperative myocardial infarction. Skeletal muscle injury associated with anterior spinal surgery resulted in significant elevations of serum CK-MB on postoperative Day 1; however, the LD-1/LD-2 ratio did not change significantly. Although false-positive elevations of serum CK- MB occurred, no patient had a CK-MB value exceeding 50 lU/liter combined with an LD-1/LD-2 ratio exceeding 1.0 (so-called “flipped LD” pattern). In evaluating suspected postoperative myocardial infarction, the authors recommend determining the isoenzymes of both serum creatine kinase and lactate dehydrogenase. In postoperative patients, elevations of CK-MB exceeding 50 IU/liter combined with an LD-1/LD-2 ratio exceeding 1.0 should not be attributed to skeletal muscle injury alone after anterior approaches to the thoracic and lumbar spine.
AB - Ten patients undergoing anterior approaches to the tho-racic and lumbar spine had prospective determinations of serum creatine kinase, lactate dehydrogenase, and their myocardial-associated isoenzymes (CK-MB and the LD-1/LD-2 ratio). None of these patients experienced postoperative myocardial infarction. Skeletal muscle injury associated with anterior spinal surgery resulted in significant elevations of serum CK-MB on postoperative Day 1; however, the LD-1/LD-2 ratio did not change significantly. Although false-positive elevations of serum CK- MB occurred, no patient had a CK-MB value exceeding 50 lU/liter combined with an LD-1/LD-2 ratio exceeding 1.0 (so-called “flipped LD” pattern). In evaluating suspected postoperative myocardial infarction, the authors recommend determining the isoenzymes of both serum creatine kinase and lactate dehydrogenase. In postoperative patients, elevations of CK-MB exceeding 50 IU/liter combined with an LD-1/LD-2 ratio exceeding 1.0 should not be attributed to skeletal muscle injury alone after anterior approaches to the thoracic and lumbar spine.
KW - Anterior spine surgery
KW - Cardiovascular complications
KW - Serum enzyme changes
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U2 - 10.1097/00007632-199003000-00005
DO - 10.1097/00007632-199003000-00005
M3 - Article
C2 - 2353254
AN - SCOPUS:0025342743
SN - 0362-2436
VL - 15
SP - 187
EP - 190
JO - Spine
JF - Spine
IS - 3
ER -