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Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

Li ZQ, Zhao YP, Jia WY, Wang X, Chen B, Shahbaz M, Nie L, Cheng L - PLoS ONE (2015)

Bottom Line: Blood pressure of another 37(25.7%) patients decreased with different degrees, although still higher than normal.Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure.We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China; Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.

ABSTRACT
Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM) is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6%) of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6%) patients turned back to normal. Blood pressure of another 37(25.7%) patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

No MeSH data available.


Related in: MedlinePlus

Comparison of the two approaches in decreasing blood pressure.(A) Changes of SBP after surgery was analyzed to investigate which approach is more effective. (B) Changes of DBP after surgery was analyzed to investigate which approach is more effective. *p<0.05.
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pone.0133828.g002: Comparison of the two approaches in decreasing blood pressure.(A) Changes of SBP after surgery was analyzed to investigate which approach is more effective. (B) Changes of DBP after surgery was analyzed to investigate which approach is more effective. *p<0.05.

Mentions: As shown in Fig 2, therapeutic effect of the two surgical approaches in decreasing hypertensive patients’ blood pressure were summarized, and the result implied that the posterior approach may exhibits better outcome in SBP (Fig 2A) but not in DBP (Fig 2B).


Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

Li ZQ, Zhao YP, Jia WY, Wang X, Chen B, Shahbaz M, Nie L, Cheng L - PLoS ONE (2015)

Comparison of the two approaches in decreasing blood pressure.(A) Changes of SBP after surgery was analyzed to investigate which approach is more effective. (B) Changes of DBP after surgery was analyzed to investigate which approach is more effective. *p<0.05.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508105&req=5

pone.0133828.g002: Comparison of the two approaches in decreasing blood pressure.(A) Changes of SBP after surgery was analyzed to investigate which approach is more effective. (B) Changes of DBP after surgery was analyzed to investigate which approach is more effective. *p<0.05.
Mentions: As shown in Fig 2, therapeutic effect of the two surgical approaches in decreasing hypertensive patients’ blood pressure were summarized, and the result implied that the posterior approach may exhibits better outcome in SBP (Fig 2A) but not in DBP (Fig 2B).

Bottom Line: Blood pressure of another 37(25.7%) patients decreased with different degrees, although still higher than normal.Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure.We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China; Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.

ABSTRACT
Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM) is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6%) of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6%) patients turned back to normal. Blood pressure of another 37(25.7%) patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

No MeSH data available.


Related in: MedlinePlus