title: The negative chronotropic effect during lumbar spine surgery: A systemic review and aggregation of an emerging model of spinal cardiac reflex.
abstract: BACKGROUND
  Hemodynamic perturbations in spine surgeries are predominantly reported in cervical and thoracic level procedures. The literature related to negative cardiovascular changes (decrease of heart rate and blood pressure) in lumbar spine procedures is still scarce and only highlighted in few case reports/letters until now.
  
  
  METHODS
  With the help of a systematic literature review with predefined criteria, we, therefore, examined and synthesized here the probable underlying common cause of these hemodynamic disturbances in lumbar spine surgeries. Data aggregation to a model was done by a case survey method and established by a cause-effect relationship.
  
  
  RESULTS
  There are only 5 cases that met our strict predefined criteria and that were aggregated to an emergent model of an autonomous reflex arc.
  
  
  CONCLUSIONS
  This review and consecutive data aggregation provides, for the first time, a concept of spinal cardiac reflex in lumbar spine surgeries.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Department of Research, University of Southampton, Southampton, UK.
authors.forename: Tumul
authors.initials: T
authors.lastname: Chowdhury
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schaller
mesh_terms: D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D002319:Cardiovascular System / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007431:Intraoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D008159:Lumbar Vertebrae; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D013119:Spinal Cord Injuries / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods