Blood Loss and Transfusion Management in Spinal Surgery

Orthopedics ◽  
1999 ◽  
Vol 22 (1) ◽  
Author(s):  
Mark B Dekutoski
Keyword(s):  
Blood Loss ◽  
Spinal Surgery

Mild hypothermia, blood loss and complications in elective spinal surgery

2004 ◽  
Vol 4 (2) ◽  
pp. 130-137 ◽  
Author(s):  
James D Guest ◽  
S Vanni ◽  
L Silbert
Keyword(s):  
Blood Loss ◽  
Spinal Surgery ◽  
Mild Hypothermia

The efficacy and safety of topical tranexamic acid for spinal surgery: a meta-analysis

2021 ◽  
Vol 27 ◽  
Author(s):  
Tai Guo ◽  
Wenxia Xuan ◽  
Haoyu Feng ◽  
Junjie Wang ◽  
Xun Ma
Keyword(s):  
Blood Loss ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Total Blood ◽  
Blood Content ◽  
Drainage Volume ◽  
Hidden Blood Loss ◽  
Postoperative Drainage

Background: Spinal surgeries are often accompanied by significant blood loss both intraoperatively and postoperatively. Excessive blood loss caused by surgery may lead to several harmful medical consequences. Tranexamic acid (TXA) is a kind of antifibrinolytic agent that has been widely used in spinal surgery. Currently, it is commonly accepted that intravenous TXA (ivTXA) can reduce blood loss in spinal fusion surgeries. Compared with ivTXA, topical TXA (tTXA) seems to be much easier to administer. This advantage provides a maximum concentration of TXA at the hemorrhagic site with little to no TXA entering the circulation. Objective: To evaluate the effect of tTXA on blood loss during and after spinal surgery via a comprehensive meta-analysis of the published data in randomized controlled trials (RCTs) and other comparative cohort studies. Methods: A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials were performed for RCTs and other comparative cohort studies on the effect of tTXA on blood loss during and after spinal surgery. The outcomes were total blood loss, hidden blood loss, intraoperative blood loss, total postoperative drainage volume, drainage tube duration postoperatively, drainage volume and drainage of blood content at postoperative day (POD) 1 and POD2, length of hospital stay, number of patients who received a blood transfusion, serum HB level at POD1, operative timespan, side effects, and complications. The final search was performed in October 2020. We followed the PRISMA guideline, and the registration number is INPLASY202160028. Results: In total, six studies with 481 patients were included. tTXA treatment, compared with the control conditions, can significantly reduce the total blood loss, hidden blood loss, total postoperative drainage volume, and several patients receiving blood transfusions; reduce the drainage volume and drainage of blood content at POD1; shorten the drainage tube duration postoperatively and length of hospital stay, and enhance the serum HB level at POD1 for spinal surgery. tTXA treatment did not significantly influence the intraoperative blood loss, drainage volume, or drainage of blood content at POD2 or the operative duration. Conclusion: Compared with control conditions, tTXA has high efficacy in reducing blood loss, and drainage volume enable quick rehabilitation and has a relatively high level of safety in spinal surgery.

Reduction of blood loss using aprotonin during spinal surgery in children for non-idiopathic scoliosis.

2002 ◽  
Vol 12 (9) ◽  
pp. 835-835 ◽  
Author(s):  
V. Colovic ◽  
R.W.M. Walker ◽  
D. Patel ◽  
S. Rushman
Keyword(s):  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Spinal Surgery

Safety and accuracy of robot-assisted versus fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery: a prospective randomized controlled trial

2019 ◽  
Vol 30 (5) ◽  
pp. 615-622 ◽  
Author(s):  
Xiaoguang Han ◽  
Wei Tian ◽  
Yajun Liu ◽  
Bo Liu ◽  
Da He ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radiation Exposure ◽  
Pedicle Screw ◽  
Spinal Surgery ◽  
Facet Joint ◽  
Postoperative Hospital Stay ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
The Mean

OBJECTIVEThe object of this study was to compare the safety and accuracy of pedicle screw placement using the TiRobot system versus conventional fluoroscopy in thoracolumbar spinal surgery.METHODSPatients with degenerative or traumatic thoracolumbar spinal disorders requiring spinal instrumentation were randomly assigned to either the TiRobot-assisted group (RG) or the freehand fluoroscopy-assisted group (FG) at a 1:1 ratio. The primary outcome measure was the accuracy of screw placement according to the Gertzbein-Robbins scale; grades A and B (pedicle breach < 2 mm) were considered clinically acceptable. In the RG, discrepancies between the planned and actual screw placements were measured by merging postoperative CT images with the trajectory planning images. Secondary outcome parameters included proximal facet joint violation, duration of surgery, intraoperative blood loss, conversion to freehand approach in the RG, postoperative hospital stay, and radiation exposure.RESULTSA total of 1116 pedicle screws were implanted in 234 patients (119 in the FG, and 115 in the RG). In the RG, 95.3% of the screws were perfectly positioned (grade A); the remaining screws were graded B (3.4%), C (0.9%), and D (0.4%). In the FG, 86.1% screws were perfectly positioned (grade A); the remaining screws were graded B (7.4%), C (4.6%), D (1.4%), and E (0.5%). The proportion of clinically acceptable screws was significantly greater in the RG than in the FG (p < 0.01). In the RG, the mean deviation was 1.5 ± 0.8 mm for each screw. The most common direction of screw deviation was lateral in the RG and medial in the FG. Two misplaced screws in the FG required revision surgery, whereas no revision was required in the RG. None of the screws in the RG violated the proximal facet joint, whereas 12 screws (2.1%) in the FG violated the proximal facet joint (p < 0.01). The RG had significantly less blood loss (186.0 ± 255.3 ml) than the FG (217.0 ± 174.3 ml; p < 0.05). There were no significant differences between the two groups in terms of surgical time and postoperative hospital stay. The mean cumulative radiation time was 81.5 ± 38.6 seconds in the RG and 71.5 ± 44.2 seconds in the FG (p = 0.07). Surgeon radiation exposure was significantly less in the RG (21.7 ± 11.5 μSv) than in the FG (70.5 ± 42.0 μSv; p < 0.01).CONCLUSIONSTiRobot-guided pedicle screw placement is safe and useful in thoracolumbar spinal surgery.Clinical trial registration no.: NCT02890043 (clinicaltrials.gov)

Aprotinin Reduces Blood Loss During Spinal Surgery in Children

Spine ◽  
2003 ◽  
Vol 28 (21) ◽  
pp. 2482-2485 ◽  
Author(s):  
Jennifer W. Cole ◽  
David J. Murray ◽  
Rebecca J. Snider ◽  
George S. Bassett ◽  
Keith H. Bridwell ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spinal Surgery

scholarly journals The safety profile of lumbar spinal surgery in elderly patients 85 years and older

2015 ◽  
Vol 39 (4) ◽  
pp. E3 ◽  
Author(s):  
Michael Y. Wang ◽  
Gabriel Widi ◽  
Allan D. Levi
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Spinal Surgery ◽  
Operative Time ◽  
Lumbar Spine Surgery ◽  
Preoperative Selection ◽  
The Mean ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

OBJECT The aging of the population will require that surgeons increasingly consider operating on elderly patients. Performing surgery safely in the elderly will require an understanding of the factors that predict successful outcomes and avoid complications. METHODS Records of patients 85 years and older undergoing elective lumbar spinal surgery were retrospectively reviewed. Microdiscectomies were excluded. Preexisting medical illnesses measured using the Charlson Comorbidity Index (CCI), American Society of Anesthesiologists (ASA) Physical Status class, age, and surgical parameters were analyzed as factors potentially predictive of complications. Ambulatory function was rated on a 4-point scale. RESULTS During the study 26 consecutive patients (mean age 87 years) with a mean ASA class of 2.6 ± 0.65 and CCI of 1.1 ± 1.27 were enrolled. The average number of levels treated was 2.17 ± 1.23, and 73% underwent fusion. The mean follow-up was 41.9 months with a minimum of 24 months, and all patients were alive at last follow-up. Average blood loss was 142 ± 184 ml, and the operative time was 183.3 ± 80.6 minutes. The mean number of levels treated was 2.17 ± 1.13 (range 1–4). Ambulatory function improved significantly by 0.59 ± 1.0 points. Five complications (19.2%) occurred in 4 patients, 2 major and 3 minor. Four complications were temporary and 1 was permanent. Patient age, blood loss, CCI score, ASA class, the number of levels treated, and fusion surgery were not statistically associated with a complication. Operative time of longer than 180 minutes (p = 0.0134) was associated with complications. CONCLUSIONS Lumbar spine surgery in patients 85 years and older can be accomplished safely if careful attention is paid to preoperative selection. Prolonged operative times are associated with a higher risk of complications.

scholarly journals THE EFFECTIVENESS OF NEW BLOOD-SAVING TECHNIQUES IN PEDIATRIC SPINAL SURGERY

2005 ◽  
pp. 095-099 ◽  
Author(s):  
Gleb Eduardovich Ulrikh ◽  
Eduard Vladimirovich Ulrikh ◽  
Elena Georgyevna Kachalova ◽  
Aleksandr Valentinovich Ushakov
Keyword(s):  
Blood Loss ◽  
Spinal Surgery ◽  
Lumbar Surgery ◽  
Isovolemic Hemodilution ◽  
Hypotensive Anesthesia ◽  
Balanced Anesthesia

The results of application of new blood-saving techniques in surgeries for scoliosis were compared in 289 patients aged from 9 months to 17 years, and the analysis of their efficiency was performed. The authors have estimated volume and velocity of blood loss, and changes in hemoglobin rate under balanced anesthesia with spinal blockade, clonidine hypotensive anesthesia and acute preoperative isovolemic hemodilution with autoplasma. The highest efficiency of spinal blockade in lumbar surgery is marked. Hemodilution was found more effective in comparison with hypotensive anesthesia in the patients with CDI correction of scoliosis. Clonidine hypotensive anesthesia (the only variant of blood-saving anesthesia used for hemivertebrae extirpation in our study) has appeared inefficient.

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