Objectives. To investigate the risk factors of total blood loss (TBL) and hidden blood loss (HBL) in adolescent idiopathic scoliosis (AIS) patients undergoing posterior orthopedic surgery. Methods. The AIS patients who visited department of spine surgery between January 2015 and December 2020 were retrospectively reviewed. Those with a history of posterior orthopedic surgery for AIS were identified, and their clinical data were collected. Gross formula was used to calculate the TBL and HBL. SPSS 20.0 was used for statistical analysis. The potential risk factors of TBL and HBL were assessed by independent t -test or univariate analysis. The risk factors of TBL and HBL were determined by multiple linear regression. Results. A total of 114 patients were included in this study. Operative time ( P < 0.001 ), postoperative platelets (PLT) ( P = 0.001 ), the number of surgical fixation segments ( P < 0.001 ), implanted screws ( P < 0.001 ), hospital stay ( P = 0.006 ), type of scoliosis ( P < 0.001 ), and correction angle of scoliosis ( P = 0.063 ) were the potential risk factors of TBL. Operative time ( P < 0.000 ), postoperative PLT ( P = 0.095 ), the number of surgical fixation segments ( P < 0.001 ), implanted screws ( P < 0.001 ), type of scoliosis ( P < 0.001 ), correction angle of scoliosis ( P = 0.073 ), and total blood volume ( P = 0.098 ) were the potential risk factors of HBL. Multiple linear regression analysis showed that operative time ( P = 0.003 ) and the number of surgical fixation segments ( P = 0.014 ) were risk factors of TBL, while the number of surgical fixation segments ( P = 0.004 ) was a risk factor of HBL. Conclusions. In AIS patients undergoing posterior internal fixation surgery, the operative time and the number of surgical fixation segments are risk factors of TBL, and the number of surgical fixation segments is a risk factor of HBL. Surgeons need to consider these factors when making surgical strategies for AIS patients.
Objectives. To investigate the correlation between tamoxifen (TAM) and lumbar intervertebral disc (IVD) degeneration (IVDD). Methods. The patients who visited the department of spine surgery from January 2015 to December 2020 were retrospectively reviewed. Those with a history of breast cancer surgery were identified and their data were collected. These data included patients' age, body mass index (BMI), menstrual history, postoperative history, drug treatment plan, and imaging data. The participants were divided into the TAM group and the non-TAM group. Lumbar IVDD was assessed by lumbar lordosis (LL), vertebral CT density, lumbar disc height index (DHI), Modic changes, and modified Pfirrmann grading score. SPSS 20 was used for statistical analysis. Results. A total of 75 patients were included in this study, 46 patients in the TAM group and 29 patients in the non-TAM group. No significant differences were present in age, BMI, postoperative history, LL, and vertebral CT density between the two groups. The DHI of L1/2 and L2/3 in the TAM group was lower compared to the non-TAM group ( P = 0.038 and P = 0.034 , respectively), while comparisons regarding the DHI of L3/4, L4/5, and L5/S1, and the average DHI between TAM and non-TAM groups were not significant. The modified Pfirrmann grading scores of the L1/2 and L2/3 IVDs in the TAM group were higher than those in the non-TAM group ( P = 0.004 and P = 0.025 , respectively). Comparisons of L3/4, L4/5, and L5/S1 between the two groups were not significant. The comparisons regarding the occurrence of Modic changes did not show a significant difference between the TAM and non-TAM groups. Conclusions. This study indicates that there might be some positive correlation between TAM use and lumbar IVDD. In particular, the degeneration of L1/2 and L2/3 has shown a correlation with TAM use.
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