Abstract
BackgroundBlood loss in posterior surgery patients with thoracolumbar metastasis posed a significant challenge to surgeons. This study aimed to explore the risk factors of blood loss in posterior surgery for patients with thoracolumbar metastasis.MethodsOne hundred forty-two patients were retrospectively reviewed. Their baseline characteristics were recorded. The Gross equation was used to calculate blood loss on a surgical day. Multivariate linear regression was used to analyze the risk factors.ResultsMean blood loss of 142 patients were 2055 ± 94 ml. Hypervascular primary tumor (kidney, thyroid and liver) (P = 0.017), wide or marginal excision (en-bloc: P = 0.001), metastasis at the lumbar spine (P = 0.033), and the presence of extraosseous tumor mass (P = 0.012) were independent risk factors of blood loss in the posterior surgery. Sub-analysis showed that wide or marginal excision (en-bloc: P < 0.001) and metastasis at lumbar spine (P = 0.007) were associated with blood loss for patients with non-hyper vascular primary tumors. Wide or marginal excision (piece-meal: P = 0.014) and the presence of an extraosseous tumor mass (P = 0.034) were associated with blood loss for patients with hypervascular primary tumors.ConclusionHypervascular primary tumor (kidney, thyroid, and liver) was an independent risk factor of blood loss in the posterior surgery. The presence of extraosseous tumor mass and wide or marginal excision (piece-meal) were independent risk factors for patients with hypervascular primary tumors. Metastasis at the lumbar spine and wide or marginal excision (en-bloc) were independent risk factors for patients with non-hyper vascular primary tumors.
Highlights
Blood loss in posterior surgery patients with thoracolumbar metastasis posed a significant challenge to surgeons
A metaanalysis showed that the mean intraoperative blood loss of patients with spinal metastasis was 2180 ml [5], and the amount of blood loss had been proven to be closely related to the occurrence of perioperative complications [6]
The study of Kumar N et al showed that the mean blood loss in posterior surgery for patients with metastasis was only 870 ± 720 ml [9], while most studies found that patients would suffer more blood loss during surgery
Summary
Blood loss in posterior surgery patients with thoracolumbar metastasis posed a significant challenge to surgeons. This study aimed to explore the risk factors of blood loss in posterior surgery for patients with thoracolumbar metastasis. The spine is the most common site of bone metastasis. Intractable pain and neurological dysfunction caused by spinal metastasis. Blood loss is a significant problem for patients with spinal metastasis receiving posterior surgery. A metaanalysis showed that the mean intraoperative blood loss of patients with spinal metastasis was 2180 ml [5], and the amount of blood loss had been proven to be closely related to the occurrence of perioperative complications [6].
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