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Partha Sarathi CI, Sinha A, Rafati Fard A, Bhatti F, Rujeedawa T, Ahmed S, Akhbari M, Bhatti A, Nouri A, Kotter MR, Davies BM, Mowforth OD. The significance of metabolic disease in degenerative cervical myelopathy: a systematic review. Front Neurol 2024; 15:1301003. [PMID: 38375465 PMCID: PMC10876002 DOI: 10.3389/fneur.2024.1301003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Degenerative cervical myelopathy (DCM) is a form of chronic spinal cord injury, with a natural history of potential for progression over time. Whilst driven by mechanical stress on the spinal cord from degenerative and congenital pathology, the neurological phenotype of DCM is likely to be modified by multiple systemic factors. The role of metabolic factors is therefore of interest, particularly given that ischaemia is considered a key pathological mechanism of spinal cord injury. The objective was therefore to synthesise current evidence on the effect of metabolism on DCM susceptibility, severity, and surgical outcomes. Methods A systematic review in MEDLINE and Embase was conducted following PRISMA guidelines. Full-text papers in English, with a focus on DCM and metabolism, including diabetes, cardiovascular disease, anaemia, and lipid profile, were eligible for inclusion. Risk of methodological bias was assessed using the Joanna Briggs Institute (JBI) critical assessment tools. Quality assessments were performed using the GRADE assessment tool. Patient demographics, metabolic factors and the relationships between metabolism and spinal cord disease, spinal column disease and post-operative outcomes were assessed. Results In total, 8,523 papers were identified, of which 57 met criteria for inclusion in the final analysis. A total of 91% (52/57) of included papers assessed the effects of diabetes in relation to DCM, of which 85% (44/52) reported an association with poor surgical outcomes; 42% of papers (24/57) discussed the association between cardiovascular health and DCM, of which 88% (21/24) reported a significant association. Overall, DCM patients with diabetes or cardiovascular disease experienced greater perioperative morbidity and poorer neurological recovery. They were also more likely to have comorbidities such as obesity and hyperlipidaemia. Conclusion Metabolic factors appear to be associated with surgical outcomes in DCM. However, evidence for a more specific role in DCM susceptibility and severity is uncertain. The pathophysiology and natural history of DCM are critical research priorities; the role of metabolism is therefore a key area for future research focus. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42021268814.
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Affiliation(s)
- Celine Iswarya Partha Sarathi
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Amil Sinha
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Amir Rafati Fard
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Faheem Bhatti
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Tanzil Rujeedawa
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Shahzaib Ahmed
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Melika Akhbari
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Aniqah Bhatti
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Aria Nouri
- Division of Neurosurgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Mark R. Kotter
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Benjamin M. Davies
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Oliver D. Mowforth
- Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom
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Takano M, Iida T, Hikata T. Persistent Orthostatic Hypotension Following Surgery for Adult Spinal Deformity: Prevalence, Risk Factors, and Cardiovascular Evaluation. Asian Spine J 2023; 17:685-692. [PMID: 37408295 PMCID: PMC10460655 DOI: 10.31616/asj.2022.0296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 07/07/2023] Open
Abstract
STUDY DESIGN Retrospective case-control study. PURPOSE To understand the prevalence of persistent orthostatic hypotension (POH), as well as its risk factors and cardiovascular pathology, in patients receiving surgery for the adult spinal deformity (ASD). OVERVIEW OF LITERATURE Although reports of the incidence of and risk factors for POH in different spinal disorders have recently been published, we are not aware of the comprehensive evaluation of POH following surgery for ASD. METHODS We examined medical records from a single central database for 65 patients receiving surgical treatment for ASD. Statistical comparisons were made between patients who experienced postoperative POH and those who did not, by examining patient and operative characteristics, such as age, sex, comorbidities, functional status, preoperative neurological function, vertebral fractures, three-column osteotomy, total operative time, estimated blood loss, length of stay, and radiographic parameters. The determinants of POH were assessed using multiple logistic regression. RESULTS We showed that postoperative POH was a complication of ASD surgery, with a 9% incidence rate. Patients with POH were statistically considerably more likely to require supported walkers due to partial paralysis and to have comorbidities including diabetes and neurodegenerative disease (ND). Furthermore, ND was an independent risk factor for postoperative POH (odds ratio, 4.073; 95% confidence interval, 1.094-8.362; p =0.020). Moreover, perioperative evaluation of the inferior vena cava showed that patients with postoperative POH had preoperative congestive heart failure and had hypovolemia lower postoperative diameter of the inferior vena cava than patients without POH. CONCLUSIONS Postoperative POH is a potential complication of ASD surgery. The most pertinent risk factor is having an ND. According to our study, patients who have surgery for ASD may experience alterations in their hemodynamics.
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Affiliation(s)
- Morito Takano
- Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, Tokyo, Japan
| | - Tsuyoshi Iida
- Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, Tokyo, Japan
| | - Tomohiro Hikata
- Department of Orthopaedic Surgery, Spine Center, Kitasato Institute Hospital, Tokyo, Japan
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Smith L, Heriseanu R. Recurrent syncope secondary to autonomic dysfunction in spinal cord injury: a case report. Spinal Cord Ser Cases 2023; 9:23. [PMID: 37391395 PMCID: PMC10313789 DOI: 10.1038/s41394-023-00585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023] Open
Abstract
High-level spinal cord injuries are often associated with autonomic impairment, which can result in orthostatic hypotension and syncope. Persistent autonomic dysfunction can manifest with disabling symptoms including recurrent syncopal events. We describe a case of autonomic failure resulting in recurrent syncopal events in a tetraplegic 66-year-old man.
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Affiliation(s)
- Leon Smith
- Spinal Injuries Unit, Royal Rehab, 235 Morrison Rd, Putney, 2112, NSW, Australia.
| | - Roxana Heriseanu
- Spinal Injuries Unit, Royal Rehab, 235 Morrison Rd, Putney, 2112, NSW, Australia
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Rajchagool B, Pattanakuhar S. Intractable postural hypotension resulting from cervical pseudomeningocele after a posterior cervical spinal surgery: a case report. Spinal Cord Ser Cases 2023; 9:14. [PMID: 37029124 PMCID: PMC10082036 DOI: 10.1038/s41394-023-00572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/09/2023] Open
Abstract
INTRODUCTION Postural hypotension (PH) is common in patients with spinal cord injury (SCI), especially those with tetraplegia. To effectively treat PH, identifying and eliminating treatable predisposing factors of PH are prerequisites before applying any interventions. CASE PRESENTATION We report a patient with post-acute cervical SCI who suffered from intractable PH resulting from pseudomeningocele causing unfavorable rehabilitation outcomes. A previously healthy 34-year-old man with complete C6 SCI resulting from C6-C7 fracture dislocation developed PH in the first week of the rehabilitation program. No specific predisposing factors including anemia, hyponatremia, and dehydration were identified. Non-pharmacological interventions and pharmacological treatment were administered to the patient without satisfactory result, causing a delay in rehabilitation progression. In the fourth week of rehabilitation program, a mass at the surgical site was detected. A cervical MRI revealed a large fluid collection at the posterior aspect of cervical spines with a size of 7.9 × 6.8 × 5.0 cm. A diagnosis of pseudomeningocele was made and surgical site debridement with closing dura by grafting was immediately conducted. One day after surgery, PH disappeared, and the patient could progress in his rehabilitation program and achieve his short-term goal within three weeks. CONCLUSION Pseudomeningocele could be one of the precipitating factors of PH in patients with tetraplegia. Healthcare providers should consider investigating pseudomeningocele in patients who have intractable and unexplainable PH.
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Affiliation(s)
- Buddharaksa Rajchagool
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sintip Pattanakuhar
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Health Services and Clinical Care Research Group, Swiss Paraplegic Research, Nottwil, Switzerland.
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Fujioka H. Latent Autonomic Dysfunction in a Chronic Cervical Spinal Injury. Cureus 2023; 15:e36785. [PMID: 37123695 PMCID: PMC10134090 DOI: 10.7759/cureus.36785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 03/30/2023] Open
Abstract
Latent autonomic dysfunction has been identified in recent years among patients with chronic cervical lesions. This paper further illustrates a precautionary case of symptomatic manifestation with an elusive trigger. A 64-year-old male, who had shown excellent neurological recovery after decompression surgery for a cervical spinal injury (modified Frankel classification from C1 to D3), complained of recurrent syncope in the chronic phase. The cause remained unidentified for two years, but it was finally discovered that the syncope was induced by a transient sympathetic overactivation that was concurrent with mental strain and alcohol intake. Abstinence completely suppressed the episodes thereafter. The case suggests the possibility that patients with a history of cervical spinal injury, no matter how normal they appear, may have asymptomatic autonomic dysfunction. Additionally, identification of the trigger can be challenging due to its dynamic and protean nature. More emphasis should be paid to autonomic evaluation for chronic cervical spinal injuries.
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Incidence and Risk Factors of Orthostasis After Primary Hip and Knee Arthroplasty. J Arthroplasty 2022; 37:S70-S75. [PMID: 35210145 DOI: 10.1016/j.arth.2022.01.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/04/2022] [Accepted: 01/15/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Postoperative orthostatic intolerance can limit mobilization after hip and knee arthroplasty. The literature is lacking on the incidence and risk factors associated with orthostatic intolerance after elective arthroplasty. METHODS A retrospective case-control study of primary total hip, total knee, and unicompartmental knee arthroplasty patients was conducted. Patients with orthostatic events were identified, and potential demographic and perioperative risk factors were recorded. Orthostatic intolerance was defined as postoperative syncope, lightheadedness, or dizziness, limiting ambulation and/or requiring medical treatment. Statistical analysis was completed using Pearson's chi-square test for categorical data and t-tests for continuous data. Binary logistic regression was performed. RESULTS A total of 500 consecutive patients were included. The overall incidence of orthostatic intolerance was 18%; 25% in total hip arthroplasty (THA) and 11% in total knee arthroplasty. On univariate analysis, significant risk factors for developing postoperative orthostatic intolerance include older age, female gender, THA surgery, lower American Society of Anesthesiologists class, absence of recreational drug use, lower estimated blood volume, lower preoperative diastolic blood pressure, spinal with monitored anesthesia care (MAC), posterior approach for THA, bupivacaine use in spinal, percent of blood loss, postoperative oxycodone or tramadol use, higher postoperative intravenous fluid volume, and lower postoperative hemoglobin. Multivariate analysis demonstrated persistent significance of female gender, THA surgery, spinal with MAC, bupivacaine use in spinal, and more intravenous fluid administered postoperatively. CONCLUSION Orthostatic intolerance affects a significant number of arthroplasty patients. Awareness of risk factors and modification of perioperative variables linked to orthostatic intolerance may assist the surgeon in choosing the appropriate surgical setting, educating patients, and improving early postoperative recovery.
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Davies BM, Mowforth O, Gharooni AA, Tetreault L, Nouri A, Dhillon RS, Bednarik J, Martin AR, Young A, Takahashi H, Boerger TF, Newcombe VF, Zipser CM, Freund P, Koljonen PA, Rodrigues-Pinto R, Rahimi-Movaghar V, Wilson JR, Kurpad SN, Fehlings MG, Kwon BK, Harrop JS, Guest JD, Curt A, Kotter MRN. A New Framework for Investigating the Biological Basis of Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 5]: Mechanical Stress, Vulnerability and Time. Global Spine J 2022; 12:78S-96S. [PMID: 35174728 PMCID: PMC8859710 DOI: 10.1177/21925682211057546] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
STUDY DESIGN Literature Review (Narrative). OBJECTIVE To propose a new framework, to support the investigation and understanding of the pathobiology of DCM, AO Spine RECODE-DCM research priority number 5. METHODS Degenerative cervical myelopathy is a common and disabling spinal cord disorder. In this perspective, we review key knowledge gaps between the clinical phenotype and our biological models. We then propose a reappraisal of the key driving forces behind DCM and an individual's susceptibility, including the proposal of a new framework. RESULTS Present pathobiological and mechanistic knowledge does not adequately explain the disease phenotype; why only a subset of patients with visualized cord compression show clinical myelopathy, and the amount of cord compression only weakly correlates with disability. We propose that DCM is better represented as a function of several interacting mechanical forces, such as shear, tension and compression, alongside an individual's vulnerability to spinal cord injury, influenced by factors such as age, genetics, their cardiovascular, gastrointestinal and nervous system status, and time. CONCLUSION Understanding the disease pathobiology is a fundamental research priority. We believe a framework of mechanical stress, vulnerability, and time may better represent the disease as a whole. Whilst this remains theoretical, we hope that at the very least it will inspire new avenues of research that better encapsulate the full spectrum of disease.
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Affiliation(s)
- Benjamin M Davies
- Department of Neurosurgery, 2152University of Cambridge, Cambridge, UK
| | - Oliver Mowforth
- Department of Neurosurgery, 2152University of Cambridge, Cambridge, UK
| | - Aref-Ali Gharooni
- Department of Neurosurgery, 2152University of Cambridge, Cambridge, UK
| | - Lindsay Tetreault
- New York University, Langone Health, Graduate Medical Education, 5894Department of Neurology, New York, NY, USA
| | - Aria Nouri
- Division of Neurosurgery, Geneva University Hospitals, 27230University of Geneva, Genève, Switzerland
| | - Rana S Dhillon
- Department of Neurosurgery, 60078St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Josef Bednarik
- Department of Neurology, University Hospital Brno and Faculty of Medicine, 37748Masaryk University, Brno, Czech Republic
| | - Allan R Martin
- Department of Neurosurgery, 8789University of California Davis, Sacramento, CA, USA
| | - Adam Young
- Department of Neurosurgery, 2152University of Cambridge, Cambridge, UK
| | - Hitoshi Takahashi
- Department of Pathology, Brain Research Institute, 12978Niigata University, Niigata, Japan
| | - Timothy F Boerger
- Department of Neurosurgery, 5506Medical College of Wisconsin, Wauwatosa, WI, USA
| | - Virginia Fj Newcombe
- Division of Anaesthesia, Department of Medicine, 2152University of Cambridge, Cambridge, UK
| | - Carl Moritz Zipser
- University Spine Center, 31031Balgrist University Hospital, Zurich, Switzerland
| | - Patrick Freund
- University Spine Center, 31031Balgrist University Hospital, Zurich, Switzerland
| | - Paul Aarne Koljonen
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, 25809The University of Hong Kong, Hong Kong, China
| | - Ricardo Rodrigues-Pinto
- Spinal Unit (UVM), Department of Orthopaedics, 112085Centro Hospitalar Universitário do Porto - Hospital de Santo António, Porto, Portugal
- 89239Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
| | - Vafa Rahimi-Movaghar
- Department of Neurosurgery, Sina Trauma and Surgery Research Center, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Jefferson R Wilson
- Division of Neurosurgery, Department of Surgery, 7938University of Toronto, Toronto, ON, Canada
| | - Shekar N Kurpad
- Department of Neurosurgery, 5506Medical College of Wisconsin, Wauwatosa, WI, USA
| | - Michael G Fehlings
- Division of Neurosurgery, Department of Surgery, 7938University of Toronto, Toronto, ON, Canada
| | - Brian K Kwon
- Vancouver Spine Surgery Institute, Department of Orthopedics, The University of British Columbia, Vancouver, BC, Canada
| | - James S Harrop
- Department of Neurological Surgery, 6559Thomas Jefferson University, Philadelphia, PA, USA
| | - James D Guest
- Department of Neurosurgery and the Miami Project to Cure Paralysis, The Miller School of Medicine, 12235University of Miami, Miami, FL, USA
| | - Armin Curt
- University Spine Center, 31031Balgrist University Hospital, Zurich, Switzerland
| | - Mark R N Kotter
- Department of Neurosurgery, 2152University of Cambridge, Cambridge, UK
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Yang Y, Chen Y, Tong B, Tian X, Yu C, Su Z, Zhang J. Orthostatic hypotension following posterior spinal fusion surgeries for spinal deformity correction in adolescents: prevalence and risk factors. BMC Musculoskelet Disord 2021; 22:1039. [PMID: 34903231 PMCID: PMC8670164 DOI: 10.1186/s12891-021-04931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Study design Retrospective case series. Objectives This study aimed to determine the prevalence and risk factors for orthostatic hypotension (OH) in adolescents undergoing posterior spinal fusion for spinal deformity correction. Methods The data of 282 consecutive adolescents who underwent posterior spinal fusion for spinal deformity correction in our center over 12 months were retrieved. Patient characteristics, including whether laminectomy or osteotomy was performed during the surgery, the occurrence of postoperative nausea and vomiting (PONV), perioperative hemoglobin albumin changes, perioperative blood transfusion, length of bed rest, willingness to ambulate, length of postoperative exercises of the lower limbs, and length of hospital stay, were collected and compared statistically between patients who did and did not develop postoperative OH. Results Of 282 patients, 197 (69.86%) developed OH postoperatively, and all cases completely resolved 5 days after the first out-of-bed exercises. Significant differences in the incidence of PONV, the willingness to ambulate and the length of postoperative exercises of the lower limbs were observed. The mean length of hospital stay of the patients with OH was longer than that of the patients without OH. Conclusion Our study suggests that temporary OH is a common manifestation following posterior spinal fusion for spinal deformity correction in adolescents. Postoperative OH may increase the length of hospital stay in these patients. Patients with PONV, who are not willing to ambulate and who perform postoperative lower limb exercises for a shorter time are more likely to have OH.
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Affiliation(s)
- Ying Yang
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Yaping Chen
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Bingdu Tong
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Xue Tian
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Chunjie Yu
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Zhe Su
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jianguo Zhang
- Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China.
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Öztürk G, Yılmaz E, Aydın M, Baydur H. Effect of using elastic-pressure socks in spinal surgery patients on orthostatic hypotension in the first mobilization. ANZ J Surg 2021; 91:2780-2787. [PMID: 34339102 DOI: 10.1111/ans.17101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Orthostatic hypotension (OH) is a common early postoperative finding in patients who undergo major surgery, and it might delay early mobilization, which is the main building block of modern perioperative care programs. The aim of this study was to determine the effect of using thigh-length elastic pressure socks in patients who undergo spinal surgery in development of OH at first mobilization after surgery. METHODS The study was a randomized-controlled intervention study. A total of 70 patients who underwent spinal surgery were included in the study. The patients were allocated randomly to the intervention group (n = 35) who used thigh-length elastic pressure socks and the control group (n = 35) which received no intervention other than routine nursing care. RESULTS It was found in the study that 2.9% of the patients in the intervention group developed OH during the first mobilization after the surgery, and 48.6% of the patients in the control group developed OH at first mobilization. The patients in the intervention group were found to have the risk ratio (RR): 0.06 times less probability of developing OH than the patients in the control group (95% confidence interval [CI]:0.01-0.42). The OH symptoms were lower in the patients in the intervention group. CONCLUSION It was found as a result of the study that using thigh-length elastic pressure socks in spinal surgery patients reduced OH development and symptoms at first mobilization after the surgery.
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Affiliation(s)
- Gülay Öztürk
- Neurosurgery Intensive Care Unit, Health Sciences University, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Emel Yılmaz
- Department of Surgical Nursing, Faculty of Health Science, Manisa Celal Bayar University, Manisa, Turkey
| | - Murat Aydın
- Department of Neurosurgery, Health Sciences University, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Hakan Baydur
- Department of Social Work, Faculty of Health Science, Manisa Celal Bayar University, Manisa, Turkey
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