title: Changes in serum creatine phosphokinase MM isoenzyme after lumbar spine surgery.
abstract: METHODS
  Serum concentrations of creatine phosphokinase and its isoenzyme were measured serially in 47 patients who underwent lumbar surgery.
  
  
  OBJECTIVE
  To analyze the significance of postoperative creatine phosphokinase MM levels as indicators of muscle trauma after lumbar surgery.
  
  
  BACKGROUND
  The authors of the present study previously have reported on iatrogenic back muscle injury in an animal model and in man. However, the relationship between the change of the creatine phosphokinase MM isoenzyme level and muscle injury after surgery has not been clarified.
  
  
  METHODS
  Peripheral venous blood samples were collected serially before surgery, just after surgery, and at 1, 3, 7, 14, and 21 days after surgery. The serum concentration of total creatine phosphokinase and its isoenzymes was measured by agarose gel electrophoresis. The serial postoperative change of the creatine phosphokinase MM isoenzyme concentration was evaluated with respect to age, gender, body weight, types and levels of surgery, and surgery time.
  
  
  RESULTS
  Creatine phosphokinase MM activity increased after surgery and reached a maximum value 1 day after surgery, followed by recovery to the normal value 1 week after surgery. The maximum concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery (P = 0.04). It was significantly higher in men than in women (P = 0.02). Serum concentration of creatine phosphokinase MM isoenzyme showed no significant correlation to the extent of muscle exposure and surgery time.
  
  
  CONCLUSIONS
  The time course of postoperative serum creatine phosphokinase MM isoenzyme activity is correlated with the histologic changes of the back muscles after surgery. The concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery. It was also significantly higher in men than in women.
authors.affiliation: Department of Orthopaedic Surgery, Toyama Medical and Pharmaceutical University, Faculty of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: H
authors.initials: H
authors.lastname: Matsui
authors.forename: H
authors.initials: H
authors.lastname: Tsuji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000097:blood*; D007527:Isoenzymes; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries*; D012727:Sex Characteristics; D013997:Time Factors; D014945:Wound Healing
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase