title: Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.
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.
authors.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.
authors.forename: Ze-qun
authors.initials: ZQ
authors.lastname: Li
authors.affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.
authors.forename: Yun-peng
authors.initials: YP
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology and Metabolism, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong Province, P. R. China; Institute of Endocrinology, Shandong Academy of Clinical Medicine, Jinan, Shandong Province, P. R. China.
authors.forename: Wen-yu
authors.initials: WY
authors.lastname: Jia
authors.affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shahbaz
authors.affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Nie
authors.affiliation: Department of Spine Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, P. R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013118:Spinal Cord Diseases / Q000150:complications / Q000601:surgery*; D055009:Spondylosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome