ABSTRACT

Spinal surgery frequently requires allogenic blood transfusion to compensate for major blood loss. Autologous blood donations are often used to reduce homologous transfusion. In the last few decades, interbody spinal fusion has gained in popularity and is frequently performed in many spinal procedures; however, there are few studies that evaluate the risk factors of additional blood transfusions in the postoperative course of degenerative spine surgery, and no studies concerning patients who have undergone interbody fusion.

In 15 consecutive months, in the same Spinal Surgery Department, 40 different elective spine surgeries were performed. These were divided into four groups: laminectomy alone, laminectomy with instrumented posterolateral fusion, laminectomy with instrumented posterolateral and interbody fusion, and extensive instrumented fusion. All patients’ surgery-related data were respectively recorded, including patient age, gender, diagnosis, preoperative hemoglobin rate, autologous blood availability, number of spinal levels decompressed and fused, duration of surgery, type of surgical procedure, and duration of hospital stay. These data were statistically analyzed to determine whether any of the variables could determine a higher risk of blood transfusion.

In a univariate analysis of factors influencing the need for blood transfusion, no significant relationship was found with patient age or availability of autologous blood before surgery. A significantly greater risk of blood transfusion was observed for females, and in cases with a low preoperative Hb rate, longer surgical times, multiple spinal levels decompressed or fused, and longer durations of hospital stay were observed. Patients undergoing instrumented posterolateral fusion or extensive instrumented fusion are also exposed to a higher risk of blood transfusion. Our linear multiple regression model showed that the patients’ gender and an increased number of levels decompressed and/or surgically fused were significant determinants for the need for blood transfusion.