The role of serum creatine kinase levels in anterior cervical spinal surgery: Change trends and risk factors

This study aimed to describe change trends in serum creatine kinase (CK) values for patients undergoing anterior cervical spinal surgery and identify risk factors that affect the CK values perioperatively, intending to decrease the degree of the iatrogenic invasiveness of the procedure. We retrospectively analyzed 122 patients undergoing anterior cervical spinal surgery from January 2019 to May 2020. For all patients, CK level was measured 1 day before the operation. Daily CK levels were evaluated on postoperative days 1 to 7. These data were analyzed in terms of age, gender, the use of microendoscopy during surgery, the number of cervical operative segments, and operative methods to determine whether these risk factors influenced postoperative CK increases. A total of 122 patients were enrolled. The preoperative average CK level was 72.7 U/L, and the average CK levels were 130.6, 122.4, 99.1, 82.8, 73.7, 63.9, and 55.4 U/L from the postoperative day (POD) 1 to POD7, respectively. CK level changes on POD1 increased with the number of operated cervical segments. However, changes were not related to age, gender, microendoscopy, or the operative method. Increased serum CK level was associated with the number of cervical operative segments, rather than age, gender, the use of microendoscopy, or the operative methods. These findings suggest that the number of cervical operative segments determined the degree of iatrogenic injury for anterior cervical spinal surgery.