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- Title
The impact of hypertension on the occurrence of postoperative spinal epidural hematoma following single level microscopic posterior lumbar decompression surgery in a single institute.
- Authors
Fujiwara, Yasushi; Manabe, Hideki; Izumi, Bunichiro; Harada, Takahiro; Nakanishi, Kazuyoshi; Tanaka, Nobuhiro; Adachi, Nobuo
- Abstract
<bold>Purpose: </bold>Postoperative spinal epidural hematoma (PSEH) is one of the most hazardous complications after spine surgery. A recent study has reported that a ≥50 mmHg increase in systolic blood pressure after extubation was a significant risk factor for symptomatic PSEH. In this paper, the impact of hypertension on PSEH occurrence was investigated.<bold>Methods: </bold>Among a total of 2468 patients who underwent single level microscopic posterior decompression surgery for lumbar spinal stenosis in a single institute, 15 (0.6%) received evacuation surgery for PSEH. Those 15 patients were investigated statistically compared with a randomly selected control group (n = 46) using the Mann-Whitney U test and multiple logistic regression analysis.<bold>Results: </bold>The univariate analysis showed that there were no significant differences in age, gender, BMI, pre-operative anti-coagulant usage, intraoperative blood loss, operation time, and the rate of patients who received pre-operative hypertension treatment. However, there were significant differences in the rate of patients who showed high blood pressure at admission (66.7 vs 6.5%) and >50 mmHg increases in blood pressure after extubation (53.3 vs 17.4%) in the univariate analysis. Moreover, postoperatively, there was a statistical difference in the amount of post-operative drainage. Multiple logistic regression analysis showed that high blood pressures at admission and poor postoperative drainage were the essential risk factors.<bold>Conclusions: </bold>Our results demonstrate that the pre-operative high blood pressure value was the most essential risk factor for PSEH, although there was no difference in the preoperative hypertension treatment. Consequently, management of pre-operative blood pressure and post-operative drainage will be crucial for preventing PSEH.
- Subjects
EPIDURAL hematoma; HYPERTENSION; THERAPEUTICS; SPINAL surgery; SURGICAL drainage; SURGICAL decompression; DISEASE risk factors; LUMBAR vertebrae surgery; HYPERTENSION epidemiology; HEMATOMA; SURGICAL complications; CASE-control method; MEDICAL drainage
- Publication
European Spine Journal, 2017, Vol 26, Issue 10, p2606
- ISSN
0940-6719
- Publication type
journal article
- DOI
10.1007/s00586-017-5165-9