Hypothyroidism and Spine Surgery: a Review of Current Findings

Abstract

Hypothyroidism is a common medical comorbidity and has been linked to adverse surgical outcomes. However, its effect on spine surgery outcomes is less clear. The aim of this review is to compile current literature to serve as a guide for spine surgeons when treating patients with hypothyroidism. In both the cervical and lumbar spine, patients with hypothyroidism are at increased risk of postoperative medical complications. Consequently, patients with hypothyroidism experience increased healthcare costs and readmission rates. However, there are some contradictory findings with some studies suggesting that hypothyroidism may have a protective effect in patients undergoing lumbar fusion, specifically against postoperative myocardial infraction and decreased inpatient mortality. When examining spine surgery outcomes, there are mixed results when considering the effect of hypothyroidism. Some studies have shown increased medical complications, hardware failure, and increased expenditure; however, other recent findings suggest possible protective effects. Future studies are needed to help create concrete guidelines for treating patients with hypothyroidism.