scholarly journals Decision Tree-based Modelling for Identification of Predictors of Blood Loss and Transfusion Requirement After Adult Spinal Deformity Surgery

10.14444/7012 ◽  
2020 ◽  
Vol 14 (1) ◽  
pp. 87-95 ◽  
Author(s):  
TINA RAMAN ◽  
DENNIS VASQUEZ-MONTES ◽  
CHRIS VARLOTTA ◽  
PETER G. PASSIAS ◽  
THOMAS J. ERRICO
Keyword(s):  
Blood Loss ◽  
Decision Tree ◽  
Spinal Deformity ◽  
Transfusion Requirement ◽  
Adult Spinal Deformity ◽  
Spinal Deformity Surgery

Effect of Tranexamic Acid on Blood Loss, D-Dimer, and Fibrinogen Kinetics in Adult Spinal Deformity Surgery

2018 ◽  
Vol 100 (9) ◽  
pp. 758-764 ◽  
Author(s):  
Ryan P. Pong ◽  
Jean-Christophe A. Leveque ◽  
Alicia Edwards ◽  
Vijay Yanamadala ◽  
Anna K. Wright ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Spinal Deformity Surgery ◽  
D Dimer

P28. Bone mineral density t-score is an independent predictor of significant blood loss in adult spinal deformity surgery

2019 ◽  
Vol 19 (9) ◽  
pp. S171
Author(s):  
Andrew B. Harris ◽  
Varun Puvanesarajah ◽  
Micheal Raad ◽  
Corinna Zygourakis ◽  
A. Jay Khanna ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Blood Loss ◽  
Bone Mineral ◽  
Spinal Deformity ◽  
Independent Predictor ◽  
Adult Spinal Deformity ◽  
Mineral Density ◽  
T Score ◽  
Spinal Deformity Surgery

scholarly journals Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Michael Y. Wang
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Intraoperative Complications ◽  
Ct Scanning ◽  
Iliac Screws ◽  
Fusion Site ◽  
Spinal Deformity Surgery ◽  
The Mean

Introduction. Adult spinal deformity (ASD) surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS) techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws.Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females). Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body.Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation.Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

Aprotinin May Decrease Blood Loss in Complex Adult Spinal Deformity Surgery, But It May Also Increase the Risk of Acute Renal Failure

Spine ◽  
2007 ◽  
Vol 32 (20) ◽  
pp. 2265-2271 ◽  
Author(s):  
Gbolahan O. Okubadejo ◽  
Keith H. Bridwell ◽  
Lawrence G. Lenke ◽  
Jacob M. Buchowski ◽  
David D. Fang ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Blood Loss ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Spinal Deformity Surgery ◽  
Decrease Blood Loss

Estimated Blood Loss is a Weak Predictor of Major Complications in Adult Spinal Deformity Surgery

2016 ◽  
Vol 16 (10) ◽  
pp. S264
Author(s):  
Eric O. Klineberg ◽  
Stacie Nguyen ◽  
Michael P. Kelly ◽  
Shay Bess ◽  
Christopher I. Shaffrey ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Major Complications ◽  
Estimated Blood Loss ◽  
Spinal Deformity Surgery

245. Predicting massive intraoperative blood loss in adult spinal deformity surgery

2020 ◽  
Vol 20 (9) ◽  
pp. S121
Author(s):  
Alexandra Soroceanu ◽  
Justin K. Scheer ◽  
Themistocles S. Protopsaltis ◽  
Munish C. Gupta ◽  
Peter G. Passias ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Intraoperative Blood Loss ◽  
Spinal Deformity Surgery

Antifibrinolytics Reduce Blood Loss in Adult Spinal Deformity Surgery

Spine ◽  
2015 ◽  
Vol 40 (8) ◽  
pp. E443-E449 ◽  
Author(s):  
Austin Peters ◽  
Kushagra Verma ◽  
Kseniya Slobodyanyuk ◽  
Thomas Cheriyan ◽  
Christian Hoelscher ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Reduce Blood Loss ◽  
Spinal Deformity Surgery

Characteristics of false-positive alerts on transcranial motor evoked potential monitoring during pediatric scoliosis and adult spinal deformity surgery: an “anesthetic fade” phenomenon

2020 ◽  
Vol 32 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Hiroki Ushirozako ◽  
Go Yoshida ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
False Positive ◽  
Adult Spinal Deformity ◽  
False Positive Rate ◽  
Multivariate Logistic Regression Analysis ◽  
Motor Evoked Potential ◽  
Scoliosis Surgery ◽  
True Negative ◽  
Duration Of Surgery ◽  
Spinal Deformity Surgery

OBJECTIVETranscranial motor evoked potential (TcMEP) monitoring may be valuable for predicting postoperative neurological complications with a high sensitivity and specificity, but one of the most frequent problems is the high false-positive rate. The purpose of this study was to clarify the differences in the risk factors for false-positive TcMEP alerts seen when performing surgery in patients with pediatric scoliosis and adult spinal deformity and to identify a method to reduce the false-positive rate.METHODSThe authors retrospectively analyzed 393 patients (282 adult and 111 pediatric patients) who underwent TcMEP monitoring while under total intravenous anesthesia during spinal deformity surgery. They defined their cutoff (alert) point as a final TcMEP amplitude of ≤ 30% of the baseline amplitude. Patients with false-positive alerts were classified into one of two groups: a group with pediatric scoliosis and a group with adult spinal deformity.RESULTSThere were 14 cases of false-positive alerts (13%) during pediatric scoliosis surgery and 62 cases of false-positive alerts (22%) during adult spinal deformity surgery. Compared to the true-negative cases during adult spinal deformity surgery, the false-positive cases had a significantly longer duration of surgery and greater estimated blood loss (both p < 0.001). Compared to the true-negative cases during pediatric scoliosis surgery, the false-positive cases had received a significantly higher total fentanyl dose and a higher mean propofol dose (0.75 ± 0.32 mg vs 0.51 ± 0.18 mg [p = 0.014] and 5.6 ± 0.8 mg/kg/hr vs 5.0 ± 0.7 mg/kg/hr [p = 0.009], respectively). A multivariate logistic regression analysis revealed that the duration of surgery (1-hour difference: OR 1.701; 95% CI 1.364–2.120; p < 0.001) was independently associated with false-positive alerts during adult spinal deformity surgery. A multivariate logistic regression analysis revealed that the mean propofol dose (1-mg/kg/hr difference: OR 3.117; 95% CI 1.196–8.123; p = 0.020), the total fentanyl dose (0.05-mg difference; OR 1.270; 95% CI 1.078–1.497; p = 0.004), and the duration of surgery (1-hour difference: OR 2.685; 95% CI 1.131–6.377; p = 0.025) were independently associated with false-positive alerts during pediatric scoliosis surgery.CONCLUSIONSLonger duration of surgery and greater blood loss are more likely to result in false-positive alerts during adult spinal deformity surgery. In particular, anesthetic doses were associated with false-positive TcMEP alerts during pediatric scoliosis surgery. The authors believe that false-positive alerts during pediatric scoliosis surgery, in particular, are caused by “anesthetic fade.”

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