ABSTRACT

Objective: Spine surgery is transitioning using minimally invasive and less exposure surgery (LES) techniques. Blood loss requiring transfusions remains a distinct complication. The authors aim to demonstrate the use of tips and techniques in decreasing the risk of transfusion in the outpatient setting.

Methods: The databases of 1512 outpatient spine cases in a single surgeon study were reviewed between 2011 and 2015. We excluded from our analysis, all cervical and lumbar epidural steroid injections as well as, discograms, rhizotomies and non-spine orthopaedic procedures (total 812).

Results: Of a total, of 700 total spine surgery cases, 300 (43%) of all spine surgeries were performed in Group 1 (cervical spine) and 400 (57%) in Group 2 (lumbar spine). Females represented 49% of the overall patient population (Group 1: 146, Group 2: 197). The mean overall age was 49.2 ± 0.8, mean age Group 1 was 50.6 ± 0.9 and Group 2 was 47.1 ± 1.2. Mean overall body mass index (BMI) was 24 ± 0.4, Group 1 mean BMI was 21.0 ± 0.7 and Group 2 BMI was 26.1 ± 0.3. The overall length of surgery was 77.4, Group 1: 65.8 ± 2.1 and Group 2: 89.0 ± 1.5. The mean overall estimated blood loss was 52.4 ± 1.7, Group 1: 43.3 ± 2.4 and Group 2: 55.4 ± 2.1. Blood loss demonstrated significant dependence on length of surgery, p < 0.0001 with dependence R = 0.451.

Conclusion: This study has demonstrated using several tips and techniques, reduction of blood loss requiring the need for transfusions. Other factors to consider include patient selection and pre-operative preparation for elective spine surgery.