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Smaller patients may lose more blood during posterior spinal arthrodesis
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Researchers found patients with smaller size and adolescent idiopathic scoliosis, cerebral palsy or Scheuermann kyphosis were at risk for greater blood volume loss during deformity-correction surgery.
The researchers reviewed a large, multicenter database to identify patients who had undergone posterior spinal arthrodesis for spinal deformity; 1,832 patients with adolescent idiopathic scoliosis (AIS), 106 patients with Scheuermann kyphosis and 196 patients with cerebral palsy were identified. The researchers used the patients’ body weight to estimate blood volume as a measure of patient size and analyzed the proportion of total circulating blood volume lost during the procedure as the study’s primary outcome.
Study results demonstrated a negative relationship between intraoperative blood loss/blood volume and blood volume in patients with AIS (coefficient, −5.8; P < .001) and in patients with cerebral palsy (coefficient, −20.3; P < .001); however, there was no significant relationship for patients with Scheuermann kyphosis (coefficient, −2.5; P < .001), according to the researchers.
Despite adjustment for several factors, the researchers concluded that these findings indicated that smaller patients lost a greater proportion of their blood volume during the procedure.
Additionally, in patients with these three conditions, males and those procedures in which a higher number of levels were fused had a greater proportion blood volume loss, according to the researchers.
The researchers concluded smaller patients have a smaller reservoir of blood volume and should be monitored closely during periods of blood loss and targeted for blood-conservation strategies. – by Robert Linnehan
Disclosures: Jain reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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