Hidden blood loss and its possible risk factors in cervical open-door laminoplasty

Jiang, Chao; Chen, Tianhe; Chen, Zexin; Sun, Ze-Ming; Zhang, Hui; Wu, Yaosen

doi:10.1177/0300060519856987

Cited by 32 publications

(43 citation statements)

References 18 publications

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“…HBL is now paid attention to and considered as an important proportion of total blood loss, but instead, it remains underestimated by most orthopedic surgeons [17]. Jiang et al [21] believed that the mean HBL was 337 ml, which was 46.8% of TBL after cervical open-door laminoplasty (EOLP). Ju et al [10] held that HBL for patients who received anterior lumbar interbody fusion (ALIF) was about 450 ml and averaged 39.2% of TBL.…”

Section: Discussionmentioning

confidence: 99%

Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

Zhou

Yang

et al. 2020

J Orthop Surg Res

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Background With respect to spinal surgeries, elucidating absolute and relative amount of hidden blood loss (HBL) is of great importance in order to avoid aforementioned potential complications. To evaluate HBL and its possible risk factors among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative diseases. Methods Between June 2018 and March 2019, 137 consecutive patients with lumbar degenerative disease, who underwent operation with MIS-TLIF technique, were enrolled in this study. The patient’s demographic characteristics and blood loss-related parameters were collected, respectively. The Pearson or Spearman correlation analysis was used to investigate an association between patient’s characteristics and HBL. Multivariate linear regression analysis was used to confirm independent risk factors of HBL. Results A total of 137 patients (86 males and 51 females, age range 19–78 years) were reviewed in our hospital. A substantial amount of HBL (488.4 ± 294.0 ml, 52.5% of TBL) occurred after MIS-TLIF. Multivariate linear regression showed that the age, muscle thickness, the Patients’ Society of Anesthesiologists (ASA) classification, patient’s blood volume (PBV), total blood loss (TBL), postoperative (i.e., day 2 or 3) hematocrit (Hct), Hct loss, and fibrinogen level were independent risk factors for HBL (P1 = 0.000, P2 = 0.002, P3 = 0.006, P4 = 0.002, P5 = 0.003, P6 = 0.048, P7 = 0.004, P8 = 0.000). Conclusion A large amount of HBL was incurred in patients undergoing MIS-TLIF. More importantly, the age, muscle thickness, ASA classification, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen level were independent risk factors for HBL in MIS-TLIF. HBL and its risk factors should be paid more attention to during the perioperative period.

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Section: Discussionmentioning

confidence: 99%

Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

Zhou

Yang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…HBL is now paid attention to and considered as an important proportion of total blood loss, but instead, it remains underestimated by most orthopaedic surgeons [17]. Jiang et al [21] believed that the mean HBL was 337 ml, which was 46.8% of TBL after cervical open-door laminoplasty (EOLP). Ju et al [10] held that HBL for patients who received anterior lumbar interbody fusion (ALIF) was about 450 ml and averaged 39.2% of TBL.…”

Section: Discussionmentioning

confidence: 99%

Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

Zhou

Jun

et al. 2020

Preprint

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Background Hidden blood loss (HBL) is still not well known or used in the setting of spine surgery. Elucidating absolute and relative amount of HBL is of great importance in order to avoid potential complications. Therefore, we evaluated HBL and its possible risk factors among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative diseases. Methods Between June 2018 and March 2019, 137 consecutive patients with lumbar degenerative disease, who underwent operation with MIS-TLIF technique were enrolled in this study. The patient’s demographic characteristics and blood loss related parameters were collected respectively. Pearson or Spearman correlations analysis were used to investigate an association between patient’s characteristics and HBL. Multivariate linear regression analysis was used to confirmed independent risk factors of HBL. Results A total of 137 patients (86 males and 51 females, age range 19-78 years) were reviewed in our hospital. A substantial amount of HBL (488.4±294.0 ml, 52.5% of TBL) occurred after MIS-TLIF. Multivariate linear regression showed that the age, muscle thickness, The Patients’ Society of Anesthesiologists (ASA) classification, patient’s blood volume (PBV), total blood loss (TBL), postoperative(i.e., day 2 or 3) hematocrit (Hct), Hct loss, and fibrinogen level were independent risk factors for HBL (P1=0.000, P2=0.002, P3=0.006, P4=0.002, P5=0.003, P6=0.048, P7=0.004, P8=0.070). Conclusion A large amount of HBL was incurred in patients undergoing MIS-TLIF. More importantly, the age, muscle thickness, ASA classification, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen level were independent risk factors for HBL in MIS-TLIF. HBL and its risk factors should be paid more attention to during perioperative period.

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“…Other factors include the patient’s gender, age, BMI, number of surgical sections, surgical methods, and operative time [ 27 , 28 ]. Jiang et al [ 12 ] reported that HBL after laminoplasty could be considerable and threaten patient’s safety, and patients required close attention during the perioperative period. Thick posterior cervical soft tissue was a risk factor for excessive HBL.…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, the actual total blood loss is significantly greater than the intraoperative blood loss and postoperative drainage only. Therefore, possible hidden haemorrhage in surgical patients should be noted and calculated according to the total and apparent blood loss [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Influence of K-line on intraoperative and hidden blood loss in patients with ossification of the posterior longitudinal ligament when undergoing unilateral open-door laminoplasty

Wang

et al. 2021

J Orthop Surg Res

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Background The K-line is a virtual straight line that connects the midpoints of the anteroposterior spinal canal diameter from C2 to C7 on a cervical lateral X-ray film. Patients with cervical ossification of the posterior longitudinal ligament (OPLL), in which the peak of the OPLL exceeds the K-line (K-line [-]), are less likely to experience sufficient decompression after laminoplasty compared with patients for whom the OPLL does not exceed the K-line (K-line [+]). This retrospective study investigated the influence of K-line position relative to the OPLL on intraoperative and hidden blood loss during unilateral open-door laminoplasty for OPLL. Methods Data were retrospectively analyzed of 108 patients with OPLL who underwent unilateral open-door laminoplasty between April 2015 and March 2018. Patient cases were categorized as K-line (+) or (-). The evaluated perioperative parameters were haematocrit, haemoglobin, intraoperative and hidden blood loss, surgical time, postoperative drainage, and complications. Radiological parameters included ossification occupancy ratio and C2-7 lordosis. Results The K-line (+) and K-line (-) groups were statistically comparable with regard to age, gender, body mass index, OPLL classification, medication history, C2-7 lordosis, postoperative haemoglobin and haematocrit, postoperative drainage, hidden blood loss, and complications. The occupying ratio of the K-line (-) group was significantly greater than that of the K-line (+) group (49.5 ± 15.3% cf. 42.3 ± 10.1%; P = 0.006), and the intraoperative blood loss was also significantly higher (286 ± 110.5 mL cf. 205.5 ± 98.3 L, P = 0.003). The hidden blood loss of the K-line (-) group was higher than that of the K-line (+), but not significantly (295.5 ± 112.6 mL cf. 265.6 ± 103.8 mL; P = 0.072). Conclusion Intraoperative and hidden blood loss associated with unilateral open-door laminoplasty can be predicted by the spatial relationship of the K-line and osteophyte. This relationship is a simple and practical index that may help surgeons determine the appropriate surgical strategy for patients with OPLL.

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Hidden blood loss and its possible risk factors in cervical open-door laminoplasty

Cited by 32 publications

References 18 publications

Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

Hidden blood loss and its possible risk factors in minimally invasive transforaminal lumbar interbody fusion

Influence of K-line on intraoperative and hidden blood loss in patients with ossification of the posterior longitudinal ligament when undergoing unilateral open-door laminoplasty

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