Blog Topic: Blood Management During Spine Deformity Surgery
In 2022, spine deformity surgery usually requires a long incision and temporary retraction of muscles from the spine. This extensive exposure of the spine helps to loosen up the spine (to get better correction), insert pedicle screws to grip the spine and place the long rods, which moves the spine in space and maintains the correction in its new position (while the spine fusion develops).
This type of exposure, and the amount of time required for these surgeries (4-6 hours), creates the opportunity to have significant blood loss. Does the amount of blood loss in surgery matter? The answer is “yes”. There is a convincing amount of published research which documents lower complications and better patient outcomes when the blood loss from surgery is low.
During surgical procedures in the operating rooms there are various methods to minimize or stop bleeding, from intravenous medications to topical materials to surgical technique. In spine deformity surgery, some of these are effective and easy to do, while others are not as effective or require changes in the execution of surgery.
So how do we minimize blood loss during pediatric spinal deformity surgery? Here are a few of methods we utilize on a daily basis:
Meticulous surgical technique: During surgery it is important to identify any and all bleeding. Electrocautery is used to stop the bleeding.
Use of tranexamic acid: This medication is given by vein, through an IV, during surgery and has been demonstrated to decrease bleeding.
Topical hemostatic agents: These materials are applied on the surfaces of muscle and bone which coagulates bleeding.
Use of red blood cell scavenging: During surgery we suction blood out of the wound and this type machine collects, filters and spins down to concentrate the blood. We can then give this concentrated back to the patient.