Peri-operative blood loss and extent of fused vertebrae in surgery for adolescent idiopathic scoliosis.

Abstract

The goal of this study was to elucidate the features of peri-operative blood loss during the posterior surgery for adolescent idiopathic scoliosis and to examine the effectiveness of homologous blood transfusion and intra-operative cell salvage. Sixty-one adolescent idiopathic scoliosis patients who have undertaken posterior fusion surgery were recruited for the study. A homologous blood transfusion was performed in all cases. Intra-operative cell salvage was also performed in all cases. The following items were investigated: 1) pre-operative and post-operative Cobb angle; 2) the extent of the fused vertebral body 3); length of the operation; 4) intra-operative and post-operative estimated blood loss; and 5) the need for allogenic transfusion. The mean pre-operative Cobb angle was 68.2, and the post-operative Cobb angle was 21.8 degrees. The mean correction rate was 70.4 %. The extent of fused vertebrae was 5 to 15 (mean 10.3). The length of the operation was 359 +/- 98 minutes. The fusion extent and length of the operation were correlated. Intra-operative blood loss was 1554 +/- 1106 ml, and post-operative blood loss was 709 +/- 321 ml. Allogenic transfusion was not performed in any of the cases. Peri-operative blood loss correlated with the length of the operation, extent of fused vertebrae and pre-operative Cobb angle. The peri-operative estimated blood loss correlated with the extent of fused vertebrae during posterior scoliosis surgery. Homologous transfusion and intra-operative cell salvage were considered to be effective for avoiding the need for allogenic transfusion.