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BMC Surgery
Published in: BMC Surgery 1/2016

Open Access 01-12-2016 | Study protocol

Effects of decompressive cervical surgery on blood pressure in cervical spondylosis patients with hypertension: a time series cohort study

Authors: Hong Liu, Hai-Bo Wang, Lin Wu, Shi-Jun Wang, Ze-Chuan Yang, Run-Yi Ma, Kathleen H. Reilly, Xiao-Yan Yan, Ping Ji, Yang-feng Wu

Published in: BMC Surgery | Issue 1/2016

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Abstract

Background

Patients with cervical spondylosis myelopathy (CSM) and complicated with hypertension are often experiencing a blood pressure decrease after taking cervical decompressive surgery in clinical observations, but how this blood pressure reduction is associated with the surgery, which cut cervical sympathetic nervous, has never been rigorously assessed. Thus, the purpose of this study is to investigate the effect of cervical decompressive surgery on blood pressure among CSM patients with hypertension.

Methods/Design

The study will be a time series cohort study. Fifty eligible patients will be selected consecutively from the Peking University First Hospital. Two 24-h ambulatory blood pressure measurement (ABPM) will be taken before the surgery, apart by at least 3 days. The patients will be followed up for another two ABPMs at 1 and 3 months after the surgery.
We will recruit subjects with cervical spondylosis myelopathy meeting operation indications and scheduled for receiving cervical decompressive surgery, aged 18–84 years, have a history of hypertension or office systolic blood pressure ≥140 mmHg on initial screening, and willing to participate in the study and provide informed consent. Exclusion criteria includes a history of known secondary hypertension, visual analogue scale (VAS) score ≥4, and unable to comply with study due to severe psychosis.
The change in systolic ABPs over the four times will be analyzed to observe the overall pattern of the blood pressure change in relation to the surgery, but the primary analysis will be the comparison of systolic ABP between the 2nd and 3rd , 4th measurements (before and after the surgery). We will also calculate the regression-to-the-mean adjusted changes in systolic ABP as sensitivity analysis. Secondary endpoints are the changes in 24 h ABPM diastolic blood pressure, blood pressure control status, the use and dose adjustment of antihypertensive medication, and the incidence of operative complications. Primary outcome analyses will be carried out using analysis of covariance, as well as the first secondary endpoint.

Discussion

This study will inform us the important knowledge about cervical sympathetic nervous system (SNS) and blood pressure. Once confirmed, it may help to produce new method for control of hypertension, which is the leading cause of death in the world.

Trial registration

The study is registered to Clinical Trials.gov (NCT02016768).
Literature
1.
Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):480–6.CrossRefPubMed
2.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217–23.CrossRefPubMed
3.
Sarafidis PA, Bakris GL. Resistant hypertension: an overview of evaluation and treatment. J Am Coll Cardiol. 2008;52(22):1749–57.CrossRefPubMed
4.
Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ. Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension. 2008;52(5):818–27.CrossRefPubMed
5.
6.
Krum H, Schlaich M, Whitbourn R, Sobotka PA, Sadowski J, Bartus K, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet. 2009;373(9671):1275–81.CrossRefPubMed
7.
Doumas M, Faselis C, Papademetriou V. Renal sympathetic denervation in hypertension. Curr Opin Nephrol Hypertens. 2011;20(6):647–53.CrossRefPubMed
8.
Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51(6):1403–19.CrossRefPubMed
9.
Yamada H, Honda T, Yaginuma H, Kikuchi S, Sugiura Y. Comparison of sensory and sympathetic innervation of the dura mater and posterior longitudinal ligament in the cervical spine after removal of the stellate ganglion. J Comp Neurol. 2001;434(1):86–100.CrossRefPubMed
10.
Kiray A, Arman C, Naderi S, Güvencer M, Korman E. Surgical anatomy of the cervical sympathetic trunk. Clin Anat. 2005;18(3):179–85.CrossRefPubMed
11.
Saylam CY, Ozgiray E, Orhan M, Cagli S, Zileli M. Neuroanatomy of cervical sympathetic trunk: a cadaveric study. Clin Anat. 2009;22(3):324–30.CrossRefPubMed
12.
Tamura T. Cranial symptoms after cervical injury. Aetiology and treatment of the Barre-Lieou syndrome. J Bone Joint Surg Br. 1989;71(2):283–7.PubMed
13.
Liu H, Ploumis A. Cervicogenic hypertension-A possible etiology and pathogenesis of essential hypertension. Hypothesis. 2012;10:1.CrossRef
14.
Symplicity HTNI, Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376(9756):1903–9CrossRef
15.
Metadata
Title
Effects of decompressive cervical surgery on blood pressure in cervical spondylosis patients with hypertension: a time series cohort study
Authors
Hong Liu
Hai-Bo Wang
Lin Wu
Shi-Jun Wang
Ze-Chuan Yang
Run-Yi Ma
Kathleen H. Reilly
Xiao-Yan Yan
Ping Ji
Yang-feng Wu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2016
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-015-0117-y

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