J Korean Soc Spine Surg.  2007 Jun;14(2):87-95. 10.4184/jkss.2007.14.2.87.

Spine Fusion Surgery for the Patient Refusing Allotransfusion

• Lee KY

• KMID: 1941660
• DOI: http://doi.org/10.4184/jkss.2007.14.2.87

Abstract

PURPOSE:To report the results of spine surgery for patients refusing allotransfusion.
MATERIALS AND METHODS
The operations were performed for 24 patients who were scheduled to undergo posterolateral fusion with internal fixation between January 2004 and March 2006. There were 7 male and 17 female patients, and the average age of the patients was 54 (range: 12~71) years. All fo these patients were indicated for posterolateral fusion with internal fixation requiring intraoperative and postoperative blood transfusion. In the whole study group, all of the patients refused to receive conventional transfusion therapy because of religious convictions. To categorize the patients by disease, there were 17 cases of spinal stenosis, two cases of spondylolytic spondylolisthesis, four cases of spinal stenosis with degenerative spondylolisthesis, and one case of neurofibromatosis scoliosis. In order to increase hemoglobin level, recombinant human erythropoietin was administered before the operation, and controlled hypotensive anesthesia, acute normovolemic hemodilution, a cell saving system, and reducing operating time methods were intraoperatively used to spare blood in spine surgery. Postoperatively, recuperative techniques were used to decrease blood loss and maximize blood production.
RESULTS
In the entire study group, there were no side effects or associated symptoms following bloodless surgery. In the followup period, there were no side effects or a lack of blood.
CONCLUSION
Our results suggest that bloodless spinal surgery is an important method that can be used for decreasing the side effects of blood transfusion, and can be considered one of the good modalities with which to satisfy medical demands in spinal surgery.

Keyword

Spine fusion surgery; Allotransfusion

MeSH Terms

Anesthesia
Blood Transfusion
Bloodless Medical and Surgical Procedures
Erythropoietin
Female
Follow-Up Studies
Hemodilution
Humans
Male
Neurofibromatoses
Scoliosis
Spinal Stenosis
Spine*
Spondylolisthesis
Erythropoietin

Figure

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  Fig. 1. Postoperative anteroposterior and lateral plain radiographs show posterior decompression and instrumented posterolateral fusion for spinal stenosis.

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  Fig. 2. Postoperative anteroposterior and lateral plain radiographs show scoliosis correction in neurofibromatosis patient.

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  Fig. 3. The average of hemoglobin (g/dl).

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