The Cell Saver in Adult Lumbar Fusion Surgery

Abstract

There was a 38% recovery rate of blood using the Cell Saver. This resulted in a decreased need for postoperative transfusion in the study group (1 U to 36% of patients) relative to the control group (1 U to 50% of patients). Significant predictors for surgery time were the number of levels fused (P < 0.0001), patient's weight (P = 0.0030), and use of Cell Saver (P = 0.0472). Significant indicators of blood loss were the number of levels fused (P < 0.0001) and surgical time (P = 0.0304). The average cost for blood-related charges in the Cell Saver group was 512 dollars versus 270 dollars per patient in the control group. CONCLUSIONS.: While the Cell Saver group did require fewer postoperative transfusions, the difference was not as much as expected. In elective fusions for degenerative conditions of the lumbar spine, blood requirements can usually be satisfied with predonation of autologous blood. With contemporary practices of predonation, the use of the Cell Saver appears to be neither necessary nor cost-effective during most elective lumbar fusions.

Efficacy of Intraoperative Cell Saver in Decreasing Postoperative Blood Transfusions in Instrumented Posterior Lumbar Fusion Patients

“…This study gives further evidence supporting the conclusion by Cha et al that blood requirements can be satisfied with preoperative blood donation. 13 To our knowledge, this is the largest number of patients reported in the literature that has studied the use of CS in instrumented posterior lumbar fusion surgery. The goal of our study was to determine whether the use of intraoperative CS decreased the number of postoperative blood transfusions, specifically the number of allogenic units transfused, as well as whether its use resulted in a higher hematocrit at discharge.…”

Cost-Effectiveness of Cell Saver in Short-segment Lumbar Laminectomy and Fusion (≤3 Levels)

“…The rate of Cell Saver utilization was only 17% in our cohort, which is signifi cantly lower than rates reported in other studies. [11][12][13][14] Few strict guidelines for the use of IOCS exist, but several accepted indications include high volume of expected blood loss, patient preference or religious objections, or lack of compatible allogeneic blood. 9 , 18 The Cell Saver cohort had several key differences in demographic characteristics and comorbidities.…”

“…[8][9][10] Studies of Cell Saver in lumbar spine surgery, however, are few in number and have produced mixed results regarding its ability to reduce the need for intraor postoperative ABT. [11][12][13][14][15] Even fewer studies have addressed transfusion costs or cost-effectiveness. 14 , 16 The aim of this study is to assess the cost-effectiveness of Cell Saver IOCS in the setting of lumbar decompression laminectomy and fusion of 3 or fewer levels.…”

Management of operative blood loss in spinal deformity surgery

“…Intraoperative cell saver use was associated Current Orthopaedic Practice www.c-orthopaedicpractice.com | 293 with decreased allogeneic transfusion in surgeries lasting over 6 h and in cases of large intraoperative blood loss (> 30% of total blood volume). Reitman et al 55 conducted a cost-analysis study in which they reviewed 102 consecutive cases of adult patients undergoing elective lumbar fusions. Similar to Bowen et al 54 they also found that cell saver use was associated with less postoperative transfusions; however, they also reported an increase in total cost.…”