What Is the Role of Autologous Blood Transfusion in Major Spine Surgery?
A Review Paper What Is the Role of Autologous Blood Transfusion in Major Spine Surgery? Naresh Kumar, MBBS, FRCS Ed, FRCS Orth., DM, Yongsheng Chen, MBBS, MRCS, Chinmoy Nath, MBBS, MS, and Eugene Hern Choon Liu, MBChB, FRCA, MPhil, MD otomy may be as high as 4.7 L.3 Blood loss may be Abstract substantial in major spine surgery for the majority of Major spine surgery is associated with significant blood spinal disorders encountered in spine practice, includ- loss, which has numerous complications. Blood loss is ing spinal stenosis, spondylolisthesis, adolescent idio- therefore an important concern when undertaking any pathic scoliosis, degenerative scoliosis, spine trauma, major spine surgery. Blood loss can be addressed by 4 reducing intraoperative blood loss and replenishing peri- and spine tumors. In 2006, Berenholtz and colleagues operative blood loss. Reducing intraoperative blood loss reported that at least 30% of 3,988 adult patients helps maintain hemodynamic equilibrium and provides a undergoing spinal fusion surgery in the United States clearer operative field during surgery. received blood transfusion. Significant blood loss can Homologous blood transfusion is still the mainstay be expected, especially during multi-level spinal decom- for replenishing blood loss in major spine surgery across pression or fusion.5 Children with neuromuscular scol- the world, despite its known adverse effects. These significant adverse effects can be seen in up to 20% of iosis, adults with osteoporotic or degenerative spine dis- patients. Autologous blood transfusion avoids the risks orders, and patients with spinal tumors are also more associated with homologous blood transfusion and has likely to experience increased bleeding during surgery.3 been shown to be cost-effective.
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