Abstract：Objective To evaluate the prevalence and risk factors of postoperative symptomatic myocardial ischemia(SMI) in surgically treated patients with degenerative spinal disorders so as to provide references in decision making and surgical planning for spinal surgeons.Methods By retrieving the medical records from January 2015 to December 2016, 462 patients were retrospectively reviewed. According to the occurrence of postoperative symptomatic myocardial ischemia, patients were divided into two groups: observation group(61 patients) and control group(401 patients). To investigate risk factors, four categorized factors were analyzed such as patient characteristics variables, preoperative cardiac functional variables, intra-operative variables, postoperative variables. Risk factors of postoperative SMI were investigated by using the two-category logistic regression analysis.Results Postoperative SMI was seen in 61 of 462 patients(13.2%). Compared with control group, the patients' ages were older (60.7 vs. 52.3), patients with previous cardiac disease (24/61 vs. 50/401) or received previous cardiac surgery (23/61 vs. 23/401) were much more, cervical disease were more common (38/61 vs. 168/401), diastolic blood pressure were lower (77.0 mmHg vs. 80.5 mmHg, 1 mmHg=0.133 kPa) and serum Ca2+ concentration were lower (2.2 mol/L vs. 2.3 mol/L) in observation group. There were significant differences between the two groups(all P values＜0.05) . Logistic regression analysis revealed that serum calcium concentration was less than 2.2 mmol/L, previous cardiac surgery and age older than 55 years were independently associated with postoperative symptomatic myocardial ischemia (all P values＜0.05).Conclusionse The prevalence of postoperative symptomatic myocardial ischemia in surgically treated patients with degenerative spinal disorders is 13.2%, potential risk factors include serum calcium concentration less than 2.2 mmol/L, previous cardiac surgery and age older than 55 years. Based on the findings, patients received previous cardiac surgery and old patients should be fully informed the risk of postoperative SMI. For spinal surgeons, it is essential to monitor the serum calcium in postoperative patient management.
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2018, Vol. 23 
