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Perioperative Variations of the Intracompartmental Pressures of the Paraspinal Muscles.
MedLine Citation:
PMID:  23274400     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY DESIGN:: Study of the influence of thoracolumbar spinal surgery through a posterior approach to the intercompartmental pressure of the paraspinal muscles. OBJECTIVE:: To create waveforms according to the pressure variations up to 24 hours postoperatively and relate these measurements to independent parameters. SUMMARY OF BACKGROUND DATA:: The existence of a paraspinal anatomic compartment and a relevant compartment syndrome has been supported theoretically, proven experimentally and confirmed in clinical cases. The perioperative variations of the intercompartmental pressures remain largely unknown. METHODS:: Five measurements were taken from both paraspinal compartments in each operated patient: Preoperatively, intraoperatively, immediately after wound closure and at six and 24 hours postoperatively. The recorded pressures were grouped as normal, elevated, or suggestive of a paraspinal compartment syndrome. Abnormal pressures were correlated with patient and operation related parameters. Forty-two patients participated in the study, 21 males and 21 females aged 13 to 83 years (mean age 51▒y). Seventy compartments were included in the final analysis. RESULTS:: Forty-two compartments developed abnormally elevated pressures postoperatively and in 22 of these, pressures suggestive of a compartment syndrome were recorded. In no case was there a clinical presentation of a true compartment syndrome. Different waveforms were created for the normal and elevated pressures group. In compartments with high measurements, pressures were likely to continue to rise at 6 and 24 hours postoperatively. The body mass index was greater in both the elevated pressures and compartment pressures groups. Procedures lasting more than two hours, extended approaches and instrumented posterior interbody fusion operations were related with lower postoperative pressures. CONCLUSIONS:: A large percentage of patients develop increased paraspinal muscle pressures up to 24 hours following posterior thoracolumbar spine surgery. These increases are related to patient and operation-related factors and may not present clinically as a compartment syndrome.
Authors:
Panagiotis D Symeonidis; Panagiotis Givissis; Evangelos Christodoulou; Ippokratis Chatzokos; Anastasios G Christodoulou
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-27
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  -     ISSN:  1539-2465     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Aristotelian University of Thessaloniki †Ascosiate Professor of Orthopaedics, Aristotelian University of Thessaloniki ‡Assistant Professor of Orthopaedics, Aristotelian University of Thessaloniki §Professor of Orthopaedics, 1st Orthopaedic Department, Aristotelian University of Thessaloniki.
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