Virginia Research Day 2022

Medical Student Research Cl inical

19 Evaluation Of Blood Pressure Changes In Patients With Cervical Spinal Stenosis

Robert Chory; Dr. Joshua Hollingsworth Corresponding author: rchory@auburn.vcom.edu

VCOM Auburn

Ultimately there was a significant change in blood pressure with an average decrease in systolic BP of 12 mmHg and a decrease in diastolic BP of 7 mmHg. Because of these results nerve root impingement should be considered as a possible cause of primary elevated blood pressure with management by cervical decompression surgery.

35 patients identified as candidates for cervical nerve root decompression surgery from a pre-operative exam were followed through surgery and a one-week post-operative exam to evaluate changes in blood pressure readings using a standard blood pressure cuff. 6 blood pressure readings were taken in total, 2 during pre-operative exam in office, 2 immediately pre-operative in hospital, 2 post-operatively in office. Blood pressure values in each setting were averaged and evaluated for a change in blood pressure between the pre-operative and post-operative setting. Average pre-operative systolic blood pressure was 137.2 mmHg, average post-operative systolic blood pressure was 125.4 with a total change of 11.8 mmHg and the largest single patient decrease of -17 mmHg. The average pre-operative diastolic blood pressure was 89.5 mmHg and average post-operative diastolic BP was 82.5 mmHg.

Impingement of parasympathetic fibers located in the cervical region in believed to result in increased sympathetic tone leading to an elevation in blood pressure. A decrease in systolic and diastolic blood pressure has historically been noted to occur after surgical decompression of the nerve root after previously being impinged, and is thought to be due to normalization of the previously decreased parasympathetic tone. However, the degree of drop in BP readings and the length of time to achieve this change is not well described in the literature. Only one similar study was identified by Liu et al which reported similar findings as our study with a-15 mmHg systolic blood pressure decrease and a-6 mmHg diastolic blood pressure decrease. The purpose of this presentation is to add to the current information about the degree of blood pressure change following cervical decompression surgery.

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