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.