Original Article

HSS Journal

, Volume 6, Issue 2, pp 160-163

The Utility of Urine Desmosine as a Marker of Lung Injury in Spine Surgery

  • Stavros G. MemtsoudisAffiliated withDepartment of Anesthesiology, Hospital for Special SurgeryWeill Cornell College of Cornell University Email author 
  • , Barry StarcherAffiliated withDepartment of Biochemistry, University of Texas Health Center
  • , Yan MaAffiliated withDepartment of Epidemiology and Biostatistics, Hospital for Special SurgeryWeill Cornell College of Cornell University
  • , Valeria BuschiazzoAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery
  • , Michael K. UrbanAffiliated withDepartment of Anesthesiology, Hospital for Special SurgeryWeill Cornell College of Cornell University
  • , Federico P. GirardiAffiliated withDepartment of Orthopedic Surgery, Hospital for Special SurgeryWeill Cornell College of Cornell University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

The objective of this prospective observational study was to determine if urine desmosine levels, a marker of lung injury, increase in response to the periopreative insults of anterior and posterior spine surgery. Desmosine, a stable breakdown product of elastin, has been proposed as a surrogate marker of lung injury in patients with COPD, tobacco use, and ARDS. We recently evaluated this marker in patients undergoing knee surgery, but the utility of desmosine as a marker of lung injury in patients undergoing spine surgery remains unstudied. In this study, we enrolled ten consecutive patients, who underwent anterior/posterior spine surgery. Patient demographics and perioperative data were recorded. Urine samples were collected at baseline, 1 day, and 3 days postoperatively and analyzed for levels of desmosine using a previously validated radioimmunoassay. Desmosine levels were 35.9 ± 18.2 pmol/mg creatinine at baseline, 38.7 ± 11 pmol/mg creatinine on postoperative day 1, and 70.5 ± 49.1 pmol/mg creatinine on postoperative day 3, respectively. Desmosine/creatinine ratios measured on day 3 postoperatively were significantly elevated compared to levels at baseline, and represented a 96.3% increase. No difference was seen between levels at baseline and day 1 postoperatively. In conclusion, we were able to show a significant increase in urine desmosine levels associated with anterior/posterior spine surgery. In the context of previous studies, our findings suggest that desmosine may be a marker of lung injury in this setting. However, further research is warranted for validation and correlation of desmosine levels to clinical markers and various degrees of lung injury.

Keywords

urine desmosine spine surgery lung injury biomarkers perioperative