Management of operative blood loss in spinal deformity surgery

Abstract

Background:Surgery for spinal deformity is associated with high levels of blood loss that may be increased with certain patient factors and complex or revision procedures that include osteotomies. Major blood loss is a vital consideration in patients undergoing complex spine surgery not only because of direct hemodynamic consequences but also because of the potential complications associated with allogeneic blood administration. The purpose of this review is to describe the current evidence supporting blood conservation techniques in spinal deformity surgery.

The Effect of Anaemia on Intra-operative Neuromonitoring Following Correction of Large Scoliosis Curves: Two Case Reports

“…Factors affecting spinal cord perfusion during corrective deformity surgery include blood pressure, Hb concentration and mechanical manipulation (through rod insertion, distraction, compression and traction) [ 4 ]. Elevating the MAP using the alpha-sympathetic effect of vasopressors improves systemic perfusion [ 12 ]. However in the face of anemia, this may paradoxically negatively impact spinal cord perfusion [ 13 ], especially while large corrective maneuvers are being performed.…”

Intraoperative Fluid Management in Patients Undergoing Spine Surgery: A Narrative Review

“…Fluid management during major spine surgery is determined by procedure- (e.g., length of surgery, risk of increased intraoperative blood loss, and prone positioning) and patient-related factors (e.g., American Society of Anesthesiologists –ASA physical status, comorbidities, and sequelae from long-term spinal deformities) ( 5 – 8 ). Over the past decade, the number of elective spine surgeries has continuously increased, especially in surgical populations at high risk of perioperative complications such as the elderly.…”