Antithrombotic Effects of Aspirin on 1- or 2-Level Lumbar Spinal Fusion Surgery

Park, Jin Hoon; Ahn, Yongchel; Choi, Byoung‐Joo; Choi, Kyung; Lee, Kyuhwak; Kim, Se Hun; Roh, Sung Woo

doi:10.1097/brs.0b013e31829a84d2

Cited by 38 publications

(30 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All the concrete information about included studies are listed in Table 1 . [ 5 , 7 , 9 , 10 ] Three studies have lumbar fusion, while 1 study combined cervical, thoracolumbar, and lumbar therapy. Two studies are anticoagulated with aspirin and the other 2 with ASA (they choose aspirin as the representation of ASA).…”

Section: Resultsmentioning

confidence: 99%

“…But some researches point out that the risk of perioperative cardiac events after major noncardiac surgery ranges from 1.4% among the general population older than 50 years of age and increases up to 3.9% in those who are at risk of cardiac disease. [ 7 ] Aspirin decreases the risk of thrombotic events and is the most widely prescribed antiplatelet agent in clinical practice. [ 18 ] A randomized controlled trial showed an absolute risk reduction of 7.2% within 30 days of major noncardiac surgery when aspirin was continued.…”

Section: Discussionmentioning

confidence: 99%

“…Despite evidence to the benefit of antiplatelet therapy in patients at risk of cardiac and cerebrovascular complications, aspirin treatment is often discontinued before surgery because of the risk of perioperative bleeding. [ 6 , 7 ] Because of the characteristic that aspirin impairs platelet aggregation, a study named “Antithrombotic Effects of Aspirin on 1- or 2-Level Lumbar Spinal Fusion Surgery”, which contains 182 samples show that to reduce the intraoperative blood loss and the postoperative blood transfusion, stopping the use of aspirin 7 to 10 days before spinal surgery is necessary. [ 7 ]…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety of continuing aspirin therapy during spinal surgery

Zhang

Wang²,

Liu³

et al. 2017

Medicine

View full text Add to dashboard Cite

Background:Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated.Objective:The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period.Methods:Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors’ reference files. We included studies that enrolled patients who underwent spinal surgery who were anticoagulated with aspirin alone and that reported bleeding or cardiovascular events as an outcome. Study quality was assessed using a validated form. 95% confidence interval (95% CI) was pooled to give summary estimates of bleeding and cardiovascular risk.Results:We identified 4 studies assessing bleeding risk associated with aspirin continuation or cardiovascular risk with aspirin discontinuation during spinal surgery. The continuation of aspirin will not increase the risk of blood loss during the spinal surgery (95% CI, −111.72 to −0.59; P = .05). Also, there was no observed increase in the operative time (95% CI, −33.29 to −3.89; P = .01) and postoperative blood transfusion (95% CI, 0.00–0.27; P = .05). But as for the cardiovascular risk without aspirin continuation and mean hospital length of stay with aspirin continuation, we did not get enough samples to make an accurate decision about their relations with aspirin.Conclusion:Patients undergoing spinal surgery with continued aspirin administration do not have an increased risk for bleeding. In addition, there is no observed increase in the operation time and postoperative blood transfusion.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety of continuing aspirin therapy during spinal surgery

Zhang

Wang²,

Liu³

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…Aspirin should not be taken for at least 1 week before a biopsy is performed, and a biopsy should not be performed for patients who have stopped warfarin until the blood coagulation index is normal. [ 47 ]…”

Section: Transthoracic Core Needle Biopsymentioning

confidence: 99%

Chinese expert consensus statement on issues related to small specimen sampling of lung cancer

Society¹,

Cancer²

2017

Endosc Ultrasound

View full text Add to dashboard Cite

“…Several series documented the increased perioperative risks/complications (e.g., hemorrhagic complications, EBL, continued postoperative drainage) when LD-ASA was continued and/or stopped for just 3 up to 7 days preoperatively vs. finding no such risks for LD-ASA stopped for 7–10 (average 9) preoperative days. [ 4 5 ] For patients undergoing 1-level lumbar fusions in Kang et al . (2011), Group 0 were on no LD-ASA, whereas Group 1 patients stopped LD-ASA (100 mg) at least 7 days (average 9 days) preoperatively.…”

Section: Introductionmentioning

confidence: 99%

When and if to stop low-dose aspirin before spine surgery?

Epstein¹

2018

Surg Neurol Int

View full text Add to dashboard Cite

Background:Prior to spine surgery (SS), we ask whether and when to stop low-dose aspirin (LD-ASA), particularly in patients with significant cardiovascular disease (CAD). Although platelets typically regenerate in 10 days, it can take longer in older patients.Methods:Here we reviewed several studies regarding the perioperative risks/complications [e.g. hemorrhagic complications, estimated blood loss (EBL), continued postoperative drainage] for continuing vs. stopping LD-ASA at various intervals prior to lumbar SS.Results:Multiple studies confirmed the increased perioperative risks for continuing LD-ASA throughout SS, or when stopping it for just 3–7 preoperative days; however, there were no increased risks if stopped between 7 to 10 days postoperatively. Other studies documented no increased perioperative risk for continuing LD-ASA throughout SS, although some indicated increased morbidity (e.g., one patient developed a postoperative hematoma resulting in irreversible paralysis).Conclusions:Several studies demonstrated more hemorrhagic complications if LD-ASA was continued throughout or stopped just 3 to up to 7 days prior to SS. However, there were no adverse bleeding events if stopped from 7–10 days preoperatively. As a spine surgeon who wishes to avoid a postoperative epidural hematoma/paralysis, I would recommend stopping LD-ASA 10 days or longer prior to SS. Nevertheless, each spine surgeon must determine what is in the “best interest” of their individual patient. Certainly, we need future randomized controlled trials to better answer: when and if to stop LD-ASA before spine surgery.

show abstract

Antithrombotic Effects of Aspirin on 1- or 2-Level Lumbar Spinal Fusion Surgery

Abstract: 3.

Cited by 38 publications

References 16 publications

Safety of continuing aspirin therapy during spinal surgery

Safety of continuing aspirin therapy during spinal surgery

Chinese expert consensus statement on issues related to small specimen sampling of lung cancer

When and if to stop low-dose aspirin before spine surgery?

Contact Info

Product

Resources

About