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Nurmukhametov R, Medetbek A, Ramirez ME, Afsar A, Sharif S, Montemurro N. Factors affecting return to work following endoscopic lumbar foraminal stenosis surgery: A single-center series. Surg Neurol Int 2023; 14:408. [PMID: 38053695 PMCID: PMC10695345 DOI: 10.25259/sni_659_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Background This study evaluates the factors affecting the return to work of endoscopic surgery for lumbar foraminal stenosis (LFS), including symptoms, functional status, complications, and reoperation rates. Methods The authors' retrospective cohort study included 100 consecutive patients (50 males and 50 females) diagnosed with LFS who underwent endoscopic surgery at Trotsky National Research Center of Surgery between January 2018 and December 2021. Results There were no significant differences in age and preoperative visual analog scale and Oswestry disability index scores between the male and female groups, time to return to work for different patient groups after undergoing endoscopic lumbar foraminotomy (ELF). However, patients with more severe stenosis and comorbidities may take longer to recover. Confounding factors were patient age, preoperative physical function, and job requirements. Conclusion This study confirms that study ELF can effectively improve symptoms associated with lumbar radiculopathy, as well as back pain, and improve patients' quality of life. Comorbidity, smoking status, and complications prolong the time to return to work following ELF surgery compared to healthy subjects.
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Affiliation(s)
- Renat Nurmukhametov
- Department of Spinal Surgery, Petrovsky National Research Centre of Surgery, Moscow, Russian Federation
| | - Abakirov Medetbek
- Department of Spinal Surgery, Petrovsky National Research Centre of Surgery, Moscow, Russian Federation
| | - Manuel Encarnacion Ramirez
- Department of Neurosurgery, Russian People’s Friendship University, United Nations Educational, Scientific and Cultural Organization (UNESCO), Digital Anatomy, Moscow, Russian Federation
| | - Afifa Afsar
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
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Pahwa B, Tayal A, Chowdhury D, Umana GE, Chaurasia B. Endoscopic versus microscopic discectomy for pathologies of lumbar spine: A nationwide cross-sectional study from a lower-middle-income country. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2023; 14:373-380. [PMID: 38268688 PMCID: PMC10805162 DOI: 10.4103/jcvjs.jcvjs_39_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/21/2023] [Indexed: 01/26/2024] Open
Abstract
Objective We conducted a cross-sectional study to assess the preference of spine surgeons between MD for microdiscectomy and endoscopic discectomy (ED) surgery for the management of lumbar pathologies in a lower-middle-income country (LMIC). Methodology An online survey assessing the preference of spine surgeons for various lumbar pathologies was developed and disseminated in "Neurosurgery Cocktail" a social media platform. Statistical analyses were performed using SPSS software with a level of significance <0.05. Results We received responses from 160 spine surgeons having a median experience of 6.75 years (range 0-42 years) after residency. Most of the spine surgeons preferred MD over ED, preference being homogeneous across all lumbar pathologies. In ED, the interlaminar approach was preferred more frequently than the transforaminal approach. The most commonly chosen contraindication for the interlaminar approach and transforaminal approach was ≥ 3 levels lumbar disc herniation (LDH) (n = 117, 73.1%) and calcified LDH (n = 102, 63.8%), respectively. There was no significant association between the type of approach preferred (MD vs. ED; and interlaminar vs. translaminar endoscopic approach) with the type of workplace and the level of experience. Conclusion Spine surgeons were inclined toward MD over ED, due to various reasons, such as a steep learning curve, lack of training opportunities, and upfront expenses. There is a pressing need for the upliftment of ED in LMICs which requires global action.
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Affiliation(s)
- Bhavya Pahwa
- Department of Neurosurgery, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Anish Tayal
- Department of Neurosurgery, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Dhiman Chowdhury
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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舒 涛, 吴 帝, 沈 茂. [Research progress of different minimally invasive spinal decompression in lumbar spinal stenosis]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2023; 37:895-900. [PMID: 37460188 PMCID: PMC10352501 DOI: 10.7507/1002-1892.202303110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/01/2023] [Indexed: 07/20/2023]
Abstract
Objective To review the application and progress of different minimally invasive spinal decompression in the treatment of lumbar spinal stenosis (LSS). Methods The domestic and foreign literature on the application of different minimally invasive spinal decompression in the treatment of LSS was extensively reviewed, and the advantages, disadvantages, and complications of different surgical methods were summarized. Results At present, minimally invasive spinal decompression mainly includes microscopic bilateral decompression, microendoscopic decompression, percutaneous endoscopic lumbar decompression, unilateral biportal endoscopy, and so on. Compared with traditional open surgery, different minimally invasive spinal decompression techniques can reduce the operation time, intraoperative blood loss, and postoperative pain of patients, thereby reducing hospital stay and saving treatment costs. Conclusion The indications of different minimally invasive spinal decompression are different, but there are certain advantages and disadvantages. When patients have clear surgical indications, individualized treatment plans should be formulated according to the symptoms and signs of patients, combined with imaging manifestations.
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Affiliation(s)
- 涛 舒
- 贵州医科大学临床医学院(贵阳 550004)Guizhou Medical University, School of Clinical Medicine, Guiyang Guizhou, 550004, P. R. China
| | - 帝求 吴
- 贵州医科大学临床医学院(贵阳 550004)Guizhou Medical University, School of Clinical Medicine, Guiyang Guizhou, 550004, P. R. China
| | - 茂 沈
- 贵州医科大学临床医学院(贵阳 550004)Guizhou Medical University, School of Clinical Medicine, Guiyang Guizhou, 550004, P. R. China
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Hu Y, Fu H, Yang D, Xu W. Clinical efficacy and imaging outcomes of unilateral biportal endoscopy with unilateral laminotomy for bilateral decompression in the treatment of severe lumbar spinal stenosis. Front Surg 2023; 9:1061566. [PMID: 36684266 PMCID: PMC9852342 DOI: 10.3389/fsurg.2022.1061566] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/10/2022] [Indexed: 01/09/2023] Open
Abstract
Objective To investigate the clinical efficacy and imaging outcomes of unilateral biportal endoscopy (UBE) with unilateral laminotomy for bilateral decompression (ULBD) in the treatment of severe lumbar spinal stenosis (SLSS). Methods We retrospectively analyzed 50 patients with SLSS treated with UBE-ULBD from October 2018 to March 2021. Visual analog scale (VAS) for back and legs pain, Oswestry disability index (ODI), modified Macnab criteria, complications, hospital stay, preoperative and postoperative dural sac cross-sectional area (DSCA) and Schizas grade, mean angle of facetectomy and osseous lateral recess decompression rate were examined. Results The mean follow-up period was 10.7 months. The mean hospital stay was 2.76 ± 1.02 days. At the final follow-up, VAS for back pain and legs pain decreased from 7.22 ± 0.95 to 1.26 ± 0.44 and from 7.88 ± 0.69 to 1.18 ± 0.39, respectively; ODI decreased from 69.88 ± 6.32% to 14.96 ± 2.75%. According to the modified Macnab criteria, the results were excellent in 24 (48%), good in 22 (44%), and fair in 4 (8%). Excellent or good results (a satisfactory outcome) were obtained in 92% of the patients. There were 2 cases of complications of dural sac tear. The postoperative DSCA was significantly enlarged compared with that before surgery, from 44.74 ± 9.85 to 126.86 ± 14.81 mm2. According to Schizas grade, the stenosis grade changes from preoperative grade C in 16 cases, grade D in 34 cases, to postoperative grade A in 40 cases, and grade B in 10 cases. The mean angle of facetectomy of the ipsilateral facet joint was 70.87 ± 5.68 ∘ , contralateral was 65.07 ± 4.98 ∘ . The decompression rate was 70.81 ± 4.43% (ipsilateral side) and 71.22 ± 3.68% (contralateral). Conclusions UBE-ULBD has a good clinical effect in the treatment of SLSS, and has achieved satisfactory results in spinal canal enlargement, undercutting of facet joints, and decompression effect. It is a safe and effective surgical for SLSS.
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Affiliation(s)
- Yutong Hu
- Graduate School, Dalian Medical University, Dalian, China,Department of Spine Surgery, Dalian Municipal Central Hospital, Dalian, China
| | - Hao Fu
- Graduate School, Dalian Medical University, Dalian, China,Department of Spine Surgery, Dalian Municipal Central Hospital, Dalian, China
| | - Dongfang Yang
- Department of Spine Surgery, Dalian Municipal Central Hospital, Dalian, China,Correspondence: Weibing Xu Dongfang Yang
| | - Weibing Xu
- Department of Spine Surgery, Dalian Municipal Central Hospital, Dalian, China,Correspondence: Weibing Xu Dongfang Yang
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Zhu MT, Li K, Hu BS, Chen CM, Lin GX. Mapping knowledge structure and themes trends in unilateral biportal endoscopic spine surgery: A bibliometric analysis. Front Surg 2022; 9:976708. [PMID: 36157413 PMCID: PMC9489928 DOI: 10.3389/fsurg.2022.976708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background The numerous benefits of unilateral biportal endoscopic (UBE) spine surgery have attracted the attention of many researchers, and a considerable number of relevant clinical studies have been published. However, global research trends in the field of UBE have received little attention. The purpose of this study was to apply bibliometric method to analyze the UBE-related publications to obtain an overview of the research trends in the field of UBE, as well as research hotspots and trends. Methods Web of Science database was searched for articles published until January 31, 2022. CiteSpace was used to analyze the data, which provided graphical knowledge maps. The following factors were applied to all literature: number of publications, distribution, h-index, institutions, journals, authors, and keywords. Results Seventy-three articles were identified. Since 2019, there has been a significant increase in the number of UBE-related publications. The country with the largest number of articles was South Korea (72.6%), followed by China (9.6%), Japan (4.1%), and Egypt (4.1%). South Korea had the highest h-index (16), followed by China (2), Japan (1), and Egypt (1). Leon Wiltse Memorial Hospital was the organization that produced the most papers (12 publications). Heo DH was the most productive author (16 papers) and was the most cited author (35 times). World Neurosurgery published the most papers on UBE (23.3%). The main research hotspots were spinal diseases, decompression, complications, learning curve, and interbody fusion. In addition, the recent concerns were “learning curve,” “interbody fusion,” “management,” and “dural tear.” Conclusions The quantity of publications on UBE research will increase, and South Korea being the major contributor and most prominent country in this field. The findings of our study will provide researchers with practical information on the field of UBE, and identification of mainstream research directions and recent hotspots.
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Affiliation(s)
- Ming-Tao Zhu
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Kunrong Li
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Bao-Shan Hu
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Chien-Min Chen
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Guang-Xun Lin
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Guang-Xun Lin
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Krakowiak M, Rulewska N, Rudaś M, Broda M, Sabramowicz M, Jaremko A, Leki K, Sokal P. Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments. J Pain Res 2022; 15:1971-1982. [PMID: 35860418 PMCID: PMC9292060 DOI: 10.2147/jpr.s356898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
Aim Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal and foraminal stenosis. The goal of the treatment is to release the stress on facets joints as well as decompress the nerve roots by enlarging the intervertebral foramina and narrowed canal recesses. Purpose To evaluate possible structural changes in the lumbar spine after implantation of an IPD on operated and adjacent segments. Patients and Methods Twenty-two patients were enrolled in the study. Preoperative MRI scans of the lumbar spine evaluated recess and foraminal stenosis prior to the application of an IPD. CT exams were performed and morphometric measurements were made to assess the size of intervertebral foramina after implantation on the operated and adjacent segments. Results Statistically significant enlargements in diameter and surface area of the intervertebral foramen were seen at the operating level. On the right and left sides, foraminal enlargement after the procedure was 1 mm in diameter. The average enlargement of the foramina surface area at the level of implantation was 10 mm2. The median interspinous distance was significantly enlarged by 3.5 mm. No significant changes in adjacent segments were observed. Clinical improvement was confirmed by the Oswestry Disability Index (ODI) and visual analog scale (VAS). Preoperative disability was reduced (mean ODI from 70.5 (12.25) to 49.5 (23.75)), as well as back pain (mean VAS from 8.0 (1.7) to 4.4 (2.6)) and pain in lower limbs (mean VAS from 7.4 (1.9) to 3.8 (2.9)). Conclusion Decompression surgery using an IPD is effective in the treatment of lumbar foraminal and canal stenosis. It provides relief of symptoms in short-term observation through enlargement of intervertebral foramina and decompression of neural roots. It reduces overload of facet joints of the operated segment and does not decrease the size of the intervertebral foramina and disc heights of adjacent segments.
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Affiliation(s)
- Mateusz Krakowiak
- Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Natalia Rulewska
- Students' Scientific Circle at the Department of Neurosurgery, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Marcin Rudaś
- Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Maciej Broda
- Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Michał Sabramowicz
- Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Andrzej Jaremko
- Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Krzysztof Leki
- Centre for Statistical Analysis, Nicolaus Copernicus University, Toruń, Poland
| | - Paweł Sokal
- Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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Librianto D, Ipang F, Saleh I, Srie Utami W, Aprilya D, Nurhayati R, Imran D. Comparison of Microscopic Decompression and Biportal Endoscopic Spinal Surgery in the Treatment of Lumbar Canal Stenosis and Herniated Disc: A One-year Follow-up. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Backgrounds. Microscopic decompression (MD) has been widely used as an alternative to open decompression. Lately, biportal endoscopic spinal surgery (BESS) - a new approach in minimal-invasive spinal surgery – has also been used with good results. Although both groups can achieve adequate lumbar decompression, there is still a lack of evidence regarding their comparison. We aim to compare the outcomes of both techniques in a one-year follow-up.
Methods. This is a retrospective study in 100 consecutive patients with symptomatic lumbar spine compression due to herniated nucleus pulposus (HNP) and lumbar canal stenosis (LCS) that was treated by either BESS or MD. Clinical evaluations using Visual Analog Score (VAS), Oswestry Disability Index (ODI), and SF-36 questionnaire were obtained. Objective data such as surgery duration, amount of postoperative drain production, and hospital length of stay were collected. Complications were noted throughout the follow-up time.
Results. The BESS group had a significantly lesser surgical duration, drain production, and length of stay. At one year follow-up, both groups achieved significant improvement in VAS, ODI, and SF-36 compared to the preoperative condition. Complications were not observed in the BESS group.
Conclusions. Both procedures were comparably effective to treat lumbar stenosis. Although this study shows superiority with BESS technique in immediate and long-term follow-up, the final choice may depend on the surgeon's preference
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Zhang J, Liu TF, Shan H, Wan ZY, Wang Z, Viswanath O, Paladini A, Varrassi G, Wang HQ. Decompression Using Minimally Invasive Surgery for Lumbar Spinal Stenosis Associated with Degenerative Spondylolisthesis: A Review. Pain Ther 2021; 10:941-959. [PMID: 34322837 PMCID: PMC8586290 DOI: 10.1007/s40122-021-00293-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
Lumbar spinal stenosis (LSS), which often occurs concurrently with degenerative spondylolisthesis (DS), is a common disease in the elderly population, affecting the quality of life of aged people significantly. Notwithstanding the frequently good effect of conservative therapy on LSS, a minority of the patients ultimately require surgery. Surgery for LSS aims to decompress the narrowed spinal canals with preservation of spinal stability. Traditional open surgery, either pure decompression or decompression with fusion, was considered effective for the treatment of LSS with or without DS. However, the long-term clinical outcomes of traditional open surgery are still unclear. Moreover, the disadvantages of conventional open surgery are extensive, examples including tissue injuries or secondary instability, with limited outcomes and significant reoperation rates. With the development and improvement of surgical tools, various minimally invasive spine surgery (MISS) methods, including indirect decompression techniques of interspinous process devices (IPDs) and direct decompression techniques such as microscopic spine surgery or endoscopic spine surgery (ESS), have been updated with enhancement. IPDs, such as Superion devices, were reported to behave with comparable physical function, disability, and symptoms outcomes to laminectomy decompression. As an emerging technique of MISS, ESS has beneficial hallmarks including minimal tissue injuries, reduced complication rates, and shortened recovery periods, thus gaining popularity in recent years. ESS can be classified in terms of endoscopic hallmarks and approaches. Predictably, with the continuous development and gradual maturity, MISS is expected to replace traditional open surgery widely in the surgical treatment of LSS associated with DS in the future.
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Affiliation(s)
- Jun Zhang
- grid.489934.bDepartment of Orthopaedics, Baoji Central Hospital, Baoji, 721008 Shaanxi China ,grid.43169.390000 0001 0599 1243School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, 710061 Shaanxi China
| | - Tang-Fen Liu
- grid.449637.b0000 0004 0646 966XInstitute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xixian District, Xi’an, 712046 Shaanxi China
| | - Hua Shan
- grid.449637.b0000 0004 0646 966XInstitute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xixian District, Xi’an, 712046 Shaanxi China
| | - Zhong-Yuan Wan
- grid.414252.40000 0004 1761 8894Department of Orthopedics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700 People’s Republic of China
| | - Zhe Wang
- grid.489934.bDepartment of Orthopaedics, Baoji Central Hospital, Baoji, 721008 Shaanxi China
| | - Omar Viswanath
- grid.134563.60000 0001 2168 186XDepartment of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ USA ,grid.64337.350000 0001 0662 7451Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA ,Valley Pain Consultants-Envision Physician Services, Phoenix, AZ USA ,grid.254748.80000 0004 1936 8876Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE USA
| | - Antonella Paladini
- grid.158820.60000 0004 1757 2611Department of MESVA, University of L’Aquila, 67100 L’Aquila, Italy
| | | | - Hai-Qiang Wang
- Institute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xixian District, Xi'an, 712046, Shaanxi, China.
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Wang H, Wang K, Lv B, Li W, Fan T, Zhao J, Kang M, Dong R, Qu Y. Analysis of risk factors for perioperative hidden blood loss in unilateral biportal endoscopic spine surgery: a retrospective multicenter study. J Orthop Surg Res 2021; 16:559. [PMID: 34526051 PMCID: PMC8442349 DOI: 10.1186/s13018-021-02698-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/29/2021] [Indexed: 02/08/2023] Open
Abstract
Background Hidden blood loss (HBL) represents an important complication of unilateral biportal endoscopic (UBE) spine surgery. This study aimed to evaluate HBL and its possible risk factors among patients undergoing UBE surgery for lumbar degenerative diseases. Methods This multicentric retrospective study was conducted in 3 different medical centers between July 2020 and April 2021. Data of patients who underwent UBE surgery were extracted by electronic medical record system. The patient’s demographic characteristics and blood loss-related parameters were recorded. We calculated the amount of HBL and explored the association between patient’s characteristics and HBL using Pearson or Spearman correlation analysis. Multivariate linear regression analysis was conducted to identify independent risk factors of HBL. Results A total of 136 patients (55 females and 81 males, age range 43 to 74 years) were included in this study. A substantial amount of HBL (469.5 ± 195.3 ml, 57.6% of TBL, total blood loss) occurred following UBE surgery. Multiple linear regression analysis indicated that the risk factors of HBL were as follows: age (P = 0.000), number of fusion levels (P = 0.015), American Society of Anesthesiologists (ASA) classification (P = 0.046), surgery time (P = 0.017), patient’s blood volume (PBV, P = 0.026), total blood loss (TBL, P = 0.001), postoperative (i.e., day 2 or 3) hematocrit (Hct, P = 0.034), Hct loss (P = 0.005), and fibrinogen (P = 0.028). Conclusions A certain amount of HBL occurs in UBE surgery and cannot be ignored in daily clinical practice. The age, number of fusion levels, ASA classification, surgery time, PBV, TBL, postoperative Hct, Hct loss, and fibrinogen are independent risk factors for HBL.
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Affiliation(s)
- Haosheng Wang
- Department of Orthopedics, Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin Province, People's Republic of China
| | - Kai Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Bin Lv
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Wenle Li
- Department of Orthopedics, Liuzhou People's Hospital, Liuzhou, Guangxi Province, People's Republic of China
| | - Tingting Fan
- Department of Endocrinology, Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China
| | - Jianwu Zhao
- Department of Orthopedics, Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin Province, People's Republic of China
| | - Mingyang Kang
- Department of Orthopedics, Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin Province, People's Republic of China
| | - Rongpeng Dong
- Department of Orthopedics, Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin Province, People's Republic of China
| | - Yang Qu
- Department of Orthopedics, Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, Jilin Province, People's Republic of China.
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