Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2007 Jun;14(2):87-95. Korean.
    Published online Jun 30, 2007.
    https://doi.org/10.4184/jkss.2007.14.2.87
    Copyright © 2007 Korean Society of Spine Surgery
    Original Article

    Spine Fusion Surgery for the Patient Refusing Allotransfusion

    Kyu Yeol Lee, M.D.
      • Department of Orthopaedic Surgery, College of Medicine, Dong-A University, Busan, Korea.
    • Address reprint requests to: Kyu Yeol Lee, M.D. Department of Orthopaedic Surgery, College of Medicine, Dong-A University, 3 Ga-1, Dongdaes-Dong, Seo-Gu, Busan, 602-715, Korea. Tel: 82-51-240-2867, Fax: 82-51-243-9764, Email: gylee@dau.ac.kr

    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 follow-up 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.

    Keywords
    Spine fusion surgery; Allotransfusion

    Figures

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

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

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

    Tables

    Table 1
    Geographic data about Patient's age, sex, diagnosis and operation name

    Table 2
    Geographic data on blood loss, operation time, changes of Hb, selected protocol

    Table 3
    Protocol for pre and postoperation

    Table 4
    Drugs for pre and postoperation

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