scholarly journals Nonsteroidal Anti-inflammatory Drugs (NSAID) Do Not Increase Blood Loss or the Incidence of Postoperative Epidural Hematomas When Using Minimally Invasive Fusion Techniques in the Degenerative Lumbar Spine

2021 ◽  
Author(s):  
Wolfgang Senker ◽  
Harald Stefanits ◽  
Matthias Gmeiner ◽  
Wolfgang Trutschnig ◽  
Jörg Franke ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Hemodynamic Instability ◽  
Complication Rates ◽  
Degenerative Lumbar Spine ◽  
Postoperative Hematoma ◽  
Increase Blood Loss ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Objective: Nonsteroidal anti-inflammatory drugs (NSAID) are essential in surgeons’ armamentarium for pain relief and antiphlogistic effects. However, spine surgeons are concerned about the drugs’ impact on coagulation, fearing hemodynamic instability due to blood loss and neurological complications due to postoperative hematoma. Furthermore, there are no clear guidelines for the use of these drugs.Materials and methods: In this retrospective subgroup analysis of a prospective observational study, we investigated 181 patients who underwent minimally invasive spinal fusions in degenerative lumbar spine pathologies. 83 patients were given NSAID perioperatively, 54 of which were female and 29 male. Of these patients who took NSAID, 39 were on NSAID until at least one day before surgery or perioperatively, whilst the others discontinued their NSAID medication at least three days before surgery. Differences in perioperative blood loss, as well as complication rates between patients with and without NSAID treatment, were investigated.Results: A significantly higher amount of blood loss during surgery and the monitoring period was encountered in patients whose spine was fused in more than one level, regardless of whether NSAID medication was taken or not and up until what point. Furthermore, it was found that taking NSAID medication had no effect on the incidence of postoperative epidural hematomas.Conclusion: Perioperatively taking NSAID medication does not increase blood loss or the incidence of postoperative hematoma in patients undergoing minimally invasive lumbar spinal fusion surgery.

scholarly journals A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities

2011 ◽  
Vol 20 (S1) ◽  
pp. 41-45 ◽  
Author(s):  
C. A. Logroscino ◽  
L. Proietti ◽  
E. Pola ◽  
L. Scaramuzzo ◽  
F. C. Tamburrelli
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Degenerative Lumbar Spine

scholarly journals Surgical Outcomes for Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion

Neurosurgery ◽  
2015 ◽  
Vol 77 (6) ◽  
pp. 847-874 ◽  
Author(s):  
Nickalus R. Khan ◽  
Aaron J. Clark ◽  
Siang Liao Lee ◽  
Garrett T. Venable ◽  
Nicholas B. Rossi ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Radiation Exposure ◽  
Interbody Fusion ◽  
Operative Time ◽  
Meta Analysis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Complication Rates ◽  
Lumbar Interbody Fusion

BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (TLIF)—or MI-TLIF—has been increasing in prevalence compared with open TLIF (O-TLIF) procedures. The use of MI-TLIF is an evolving technique with conflicting reports in the literature about outcomes. OBJECTIVE: To investigate the impact of MI-TLIF in comparison with O-TLIF for early and late outcomes by using the Visual Analog Scale for back pain (VAS-back) and the Oswestry Disability Index (ODI). Secondary end points include blood loss, operative time, radiation exposure, length of stay, fusion rates, and complications between the 2 procedures. METHODS: During August 2014, a systematic literature search was performed identifying 987 articles. Of these, 30 met inclusion criteria. A random-effects meta-analysis was performed by using both pooled and subset analyses based on study type. RESULTS: Our meta-analysis demonstrated that MI-TLIF reduced blood loss (P < .001), length of stay (P < .001), and complications (P = .001) but increased radiation exposure (P < .001). No differences were found in fusion rate (P = .61) and operative time (P = .34). A decrease in late VAS-back scores was demonstrated for MI TLIF (P < .001), but no differences were found in early VAS-back, early ODI, and late ODI. CONCLUSION: MI-TLIF is associated with reduced blood loss, decreased length of stay, decreased complication rates, and increased radiation exposure. The rates of fusion and operative time are similar between MI-TLIF and O-TLIF. Differences in long-term outcomes in MI-TLIF vs O-TLIF are inconclusive and require more research, particularly in the form of large, multi-institutional prospective randomized controlled trials.

scholarly journals Motion-Cyclo-oxygenase-2 Selective Nonsteroidal Anti-Inflammatory Drugs are as Safe as Placebo for the Stomach: Arguments for the Motion

2003 ◽  
Vol 17 (5) ◽  
pp. 339-341 ◽  
Author(s):  
Richard H Hunt
Keyword(s):  
Small Bowel ◽  
Blood Loss ◽  
Previous History ◽  
High Dose ◽  
Duodenal Ulcers ◽  
Low Dose Aspirin ◽  
History Of ◽  
Important Addition ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Traditional nonsteroidal anti-inflammatory drugs (NSAIDs) are known to cause gastritis, gastric and duodenal ulcers, and gastrointestinal (GI) blood loss, as well as alterations in small bowel permeability. Patients at a high risk for these complications include those who are older than 60 years of age, those with a previous history of complicated peptic disease and bleeding, and those who take high dose or multiple NSAIDs, including low dose aspirin, corticosteroids or anticoagulants. The introduction of selective inhibitors of cyclo-oxygenase-2 (COX-2) has provided effective treatment of inflammatory arthritis and musculoskeletal pain, with dramatic reductions in the risk of GI adverse events. The two most widely prescribed coxibs are celecoxib and rofecoxib, and others are being developed. Endoscopic studies have revealed that coxibs are only half as likely to induce upper GI ulceration than are traditional NSAIDs, and are as safe as placebo. Furthermore, the newer drugs do not cause excessive blood loss from the GI tract and do not affect small bowel permeability. The Vioxx Gastrointestinal Outcomes Research Study (VIGOR) revealed that the incidence of myocardial infarction was significantly lower with naproxen than rofecoxib, although this study was not designed to look at this endpoint. Coxibs are an important addition to the pharmacotherapy of inflammatory disease.

Gastro-Intestinal Blood Loss during Administration of Indoprofen, Aspirin and Ibuprofen

1977 ◽  
Vol 5 (3) ◽  
pp. 155-160 ◽  
Author(s):  
G Bianchi Porro ◽  
G Corvi ◽  
L M Fuccella ◽  
G C Goldaniga ◽  
G Valzelli
Keyword(s):  
Blood Loss ◽  
Acetylsalicylic Acid ◽  
Fold Increase ◽  
Acute Effect ◽  
Gastrointestinal Mucosa ◽  
Order Of Magnitude ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Faecal Blood Loss

The acute effect of three non-steroidal anti-inflammatory drugs, ibuprofen, acetylsalicylic acid (ASA) and indoprofen, on faecal blood loss was investigated in 15 subjects by means of 51Cr-labelled erythrocytes. Ibuprofen (900 mg/day for 5 days) and indoprofen capsules and tablets (300 mg and 600 mg/day for 5 days, respectively) slightly increased the amount of blood eliminated in faeces. The increase was of the same order of magnitude for both doses of indoprofen. ASA (1,500 mg/day for 5 days) caused about a 6-fold increase in blood loss. Four days after withdrawal of ASA, faecal blood was still about twice as high as in faeces of subjects given ibuprofen and indoprofen. The method appears sensitive and reliable for comparison of the immediate effect of anti-inflammatory drugs on gastrointestinal mucosa.

scholarly journals Comparative analysis of transforaminal lumbar interbody fusion versus posterolateral instrumented fusion in degenerative lumbar spine disorders

2020 ◽  
Vol 27 (2) ◽  
pp. 173-178
Author(s):  
Sanjay Yadav ◽  
Saurabh Singh ◽  
Raj Kumar Arya ◽  
Alok Kumar ◽  
Ishan Kumar ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Inclusion Criteria ◽  
Degenerative Lumbar Spine ◽  
Significant Difference ◽  
Spine Disorders

Objectives: Spinal fusion is an effective treatment for degenerative lumbar spine; however, conflicting results exist regarding the best procedure. This study compares the clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) versus instrumented posterolateral fusion (PLF) in patients of degenerative lumbar spine disorders. Methods: Of the total 37 patients, 16 patients were operated with TLIF and 21 were operated with instrumented PLF with bone grafting. Duration of the study was from June 2017 to June 2019. Patients fulfilling the inclusion criteria were included in the study. Inclusion criteria were (1) age of patient ranging from 18 years to 70 years, (2) involvement of single level, (3) diagnosis of degenerative spine disease, and (4) minimum follow-up of 1 year. Radiographic parameters such as slippage of vertebrae, anterior and posterior disc heights, local disc lordosis, T12–S1 angle were measured, and fusion were assessed; comparison between preoperative and postoperative parameters was also done. Clinical outcome score was obtained using visual analog scale (VAS) and Oswestry disability index (ODI). Statistical analysis was done using SPSS software. Results: No significant difference was found in ODI and VAS between TLIF and PLF. Restoration of disc height and improvement of local disc lordosis was better in the TLIF group than in the PLF group. The fusion rate was 87.5% in the TLIF group and 81% in the instrumented PLF group. Amount of blood loss was slightly higher in the TLIF group (319.69 ± 53.8 mL) than in the instrumented PLF group (261.19 ± 34.9 mL). Operating time was also slightly higher in TLIF (133 ± 6.02 min) than in instrumented PLF (90.71 ± 6.3 min). Conclusion: TLIF is superior to instrumented PLF in terms of restoration of anterior and posterior disc heights and improvement in local disc lordosis and higher fusion rate, however it requires greater surgical expertise and more experience. Because of anterior cage support, early weight-bearing mobilization can be allowed in the TLIF group compared to the PLF group. Surgical time and blood loss were slightly higher in cases of TLIF than instrumented PLF.

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