The further exploration of hidden blood loss in posterior lumbar fusion surgery

Abstract Objective: This research aimed at examining the volume of hidden blood loss (HBL) in lumbar fusion surgery with two kinds of screw implanting techniques and evaluating HBL-related factors in the patient population receiving lumbar fusion surgeryMethods: A retrospective study was conducted targeting 104 patients with lumbar degenerative diseases and treated with TLIF from January 2017 to December 2018, and the CBT (cortical bone trajectory) technique and conventional PS (pedicle screw) technique were applied to 45 and 59 patients, respectively. The collected data covered patients’ weight, height, BMI index, and operation time. It was followed by the recording of preoperative and postoperative hematocrit (HCT) of patients, based on which the blood loss was calculated by Gross’s formula. Results: The CBT and PS groups presented no significant difference in demographic characteristics (p > 0. 05), but the average HBL of 280±227 mL and 298±232 mL as well as the average TBL of 603±232 mL and 728±321 mL, respectively. It indicated the difference of the two groups in TBL, but no significant difference in HBL. In addition, an association of HBL of two screw techniques with operation time, concomitant disease and age was found from the data analysis.Conclusion: Large total blood loss incurred in lumbar fusion surgery, specifically with a lower value by the CBT technique than by the PS technique. Nonetheless, HBL occupied a large part of the total blood loss and it was identified in both groups. Thus, a good understanding of HBL will improve postoperative rehabilitation and guarantee patients’ safety.

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Microdialysis of paraspinal muscle in healthy volunteers and patients underwent posterior lumbar fusion surgery

European Spine Journal ◽

10.1007/s00586-009-1021-x ◽

2009 ◽

Vol 18 (11) ◽

pp. 1604-1609 ◽

Cited By ~ 6

Author(s):

Gang Ren ◽

Søren Eiskjær ◽

Jon Kaspersen ◽

Finn Bjarke Christensen ◽

Sten Rasmussen

Keyword(s):

Healthy Volunteers ◽

Lumbar Fusion ◽

Paraspinal Muscle ◽

Fusion Surgery ◽

Posterior Lumbar Fusion ◽

Lumbar Fusion Surgery

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A case of pituitary apoplexy following posterior lumbar fusion surgery

Journal of Neurosurgery Spine ◽

10.3171/2015.3.spine14792 ◽

2015 ◽

Vol 23 (5) ◽

pp. 598-601 ◽

Cited By ~ 3

Author(s):

Akın Akakın ◽

Baran Yılmaz ◽

Murat Şakir Ekşi ◽

Türker Kılıç

Keyword(s):

Pituitary Adenoma ◽

Pituitary Apoplexy ◽

Lumbar Fusion ◽

Rare Complication ◽

Interdisciplinary Approach ◽

Electrolyte Imbalance ◽

Fusion Surgery ◽

Posterior Lumbar Fusion ◽

Lumbar Fusion Surgery ◽

First Case

Pituitary adenoma is a common primary brain neoplasm. Pituitary apoplexy (PA) is a rare complication of pituitary adenoma and occurs as the result of sudden tumor growth and following different comorbidities. The authors describe the first case of PA following posterior lumbar fusion surgery performed while the patient was prone. In patients with a preexisting pituitary adenoma, thorough clinical and laboratory investigations should be conducted using an interdisciplinary approach before any planned surgery. In unknown cases of pituitary adenoma, PA should be kept in mind for the differential diagnosis in a case with headache, nausea, vomiting, ophthalmoplegia, visual loss, and electrolyte imbalance concurrent with an ongoing disease state.

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Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02032-7 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Tao Wang ◽

Wenyuan Ding

Keyword(s):

Risk Factors ◽

Lumbar Fusion ◽

Meta Analysis ◽

Adjacent Segment Degeneration ◽

Cochrane Library ◽

Adjacent Segment ◽

Fusion Surgery ◽

Posterior Lumbar Fusion ◽

Lumbar Fusion Surgery ◽

History Of

Abstract Study design A meta-analysis. Objective We performed a meta-analysis to explore the incidence and risk factors of adjacent segment degeneration (ASD) after posterior lumbar fusion surgery. Methods An extensive search of the literature was performed in English database of PubMed, Embase, and Cochrane Library, and Chinese database of CNKI and WANFANG (up to May 2020). We collected factors including demographic data, surgical factor, and sagittal parameters. Data analysis was conducted with RevMan 5.3 and STATA 12.0. Results Finally, 19 studies were included in the final analysis. In our study, the rate of ASD after posterior lumbar fusion surgery was 18.6% (540 of 2896). Our data also showed that mean age, body mass index (BMI), the history of smoking and hypertension, preoperative adjacent disc degeneration, long-segment fusion, preoperative superior facet violation, high lumbosacral joint angle, pre- and post-operative L1-S1 sagittal vertical axis (SVA), post-operative lumbar lordosis (LL), and preoperative pelvic incidence (PI) were associated with the development of ASD. However, gender, history of diabetes, bone mineral density (BMD), preoperative Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA), the type of fusion (PLIF vs TLIF), type of bone graft (auto- vs allograft), fusion to S1(vs non-fusion to S1), diagnose (lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis), preoperative pelvic tilt (PT), LL and sacral slope (SS), post-operative SS, PT and PI were not associated with the development of ASD. Conclusions In our study, many factors were correlated with the risk of ASD after posterior lumbar fusion surgery. We hope this article can provide a reference for spinal surgeons in treatment for lumbar degenerative diseases.

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The Effect of Tranexamic Acid Administration on Early Endothelial Damage Following Posterior Lumbar Fusion Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10071415 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1415

Author(s):

Hye Jin Kim ◽

Bora Lee ◽

Byung Ho Lee ◽

So Yeon Kim ◽

Byongnam Jun ◽

...

Keyword(s):

Postoperative Complications ◽

Tranexamic Acid ◽

Lumbar Fusion ◽

Endothelial Glycocalyx ◽

Control Group ◽

Fusion Surgery ◽

Posterior Lumbar Fusion ◽

Lumbar Fusion Surgery ◽

Post Surgery

Tranexamic acid (TXA) protects against endothelial glycocalyx injury in vitro. We aimed to evaluate whether TXA could protect against endothelial glycocalyx degradation in patients undergoing posterior lumbar fusion surgery. Patients aged 30–80 years were enrolled. The TXA group was administered a loading dose of 10 mg/kg, followed by a 1 mg/kg/h infusion. Serum syndecan-1 and heparan sulfate concentrations, which are biomarkers of glycocalyx degradation, were measured at preoperative baseline (T0), immediately post-surgery (T1), and 2 h post-surgery (T2). Postoperative complications were assessed, including hypotension, desaturation, and acute kidney injury. Among the 121 patients who completed the study, 60 received TXA. There were no significant differences in the marker concentrations at each time point. However, the postoperative increase in syndecan-1 levels from baseline was significantly attenuated in the TXA group compared with the control group (median (interquartile range); T1 vs. T0: −1.6 (−5.3–2.6) vs. 2.2 (−0.7–4.8), p = 0.001; T2 vs. T0: 0.0 (−3.3–5.5) vs. 3.6 (−0.1–9.3), p = 0.013). Postoperative complications were significantly associated with the magnitude of the change in syndecan-1 levels (for T2 vs. T0: odds ratio: 1.08, 95% confidence interval: 1.02–1.14, p = 0.006). TXA administration was associated with reduced syndecan-1 shedding in patients undergoing posterior lumbar fusion surgery.

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