Serum creatine kinase and lactate dehydrogenase changes after anterior approaches to the thoracic and lumbar spine

Dane K. Wukich, Bruce E. Van Dam, Geoffrey M. Graeber, Thomas Martyak

Research output: Contribution to journalArticle

9 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)187-190
Number of pages4
Issue number3
StatePublished - Mar 1990



  • Anterior spine surgery
  • Cardiovascular complications
  • Serum enzyme changes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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