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  • Effects of Discontinuance of Preoperative Anti-platelet Medication in Multi-level Thoracolumbar Spine Surgery

    Final Number:
    344

    Authors:
    Dong Wuk Son; Geun Sung Song

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: The aims of our study were to evaluate the perioperative morbidities of patients who was taking anti-platelet medication in multi-level thoracolumbar spine surgery.

    Methods: We retrospectively reviewed the medical records of 147 patients who underwent multi-level spine surgery From January 2009 to November 2014 at our institution. Cervical spine surgery and simple lumbar laminectomy operation were excluded. These patients were divided into two groups based on the preoperative anti-platelet medication. Anti-platelet group (n=13) was discontinued the anticoagulation therapy 7 days before the spine surgery was performed. Control group (n=134) didn’t medicate any anti-platelet medication. Age, BMI, medical history, operation time, intraoperative estimated blood loss, ASA score, transfusion of blood products were assessed. The incidence of postoperative major complications such as the spinal epidural hematoma, operative site infection were also compared.

    Results: The overall postoperative complication rates was similar in two groups. The incidences of major complication rates were 7.7%(1/13) for anti-plate groups, 9.7%(13/134) for control groups. In anti-platelet groups, one patient experienced surgical site infection and revision operation was performed. This complication has no relationship with bleeding tendency. Severe bleeding related complication in the perioperative period didn’t appear in both groups. Multiple logistic regression analysis demonstrated that BMI and estimated intraoperative blood loss is independent predictors of operation related complications . In consideration with intraoperative parameters such as estimated intraoperative blood loss and intraoperative transfusion rates, the amount of intraoperative bleeding loss in control group is more severe.

    Conclusions: Surgical complication related perioperative bleeding had serious influences on the surgical outcome. So, Spine surgeons have been reluctant to perform multi-level spine surgery on the patient who are taking anti-coagulant medication. According to our study, the pre-operative anti-coagulant therapy did not increase the bleeding related complication and spine operations can be performed relatively safe if we try to consider carefully co-morbidities of patients

    Patient Care: Surgical complication related perioperative bleeding had serious influences on the surgical outcome. So, Spine surgeons have been reluctant to perform multi-level spine surgery on the patient who are taking anti-coagulant medication. According to our study, the pre-operative anti-coagulant therapy did not increase the bleeding related complication and spine operations can be performed relatively safe if we try to consider carefully co-morbidities of patients

    Learning Objectives: Surgical complication related perioperative bleeding had serious influences on the surgical outcome. So, Spine surgeons have been reluctant to perform multi-level spine surgery on the patient who are taking anti-coagulant medication. According to our study, the pre-operative anti-coagulant therapy did not increase the bleeding related complication and spine operations can be performed relatively safe if we try to consider carefully co-morbidities of patients

    References:

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