Hidden blood loss of minimally invasive hybrid lumbar interbody fusion: an analysis of influencing factors

Abstract

Background Lumbar interbody fusion(LIF) is the leading way to treat Lumbar Degenerative Diseases(LDD). At present, there is a lack of research on the influencing factors of hidden blood loss in minimally invasive hybrid lumbar interbody fusion. This study comprehensively explores the definite factors affecting the hidden blood loss in minimally invasive hybrid lumbar interbody fusion. Materials and methods One hundred patients with Lumbar degenerative diseases who underwent minimally invasive hybrid lumbar interbody fusion in our center were included. Demographics, laboratory data, surgical data, and radiographic data were collected. The Gross equation and Sehat equation were used to calculate the estimated value of hidden blood loss. Multi-factor linear regression analysis was used to determine the influencing factors of hidden blood loss. Result We reviewed and collected 100 patients who underwent minimally invasive hybrid approach, mean age 65 ± 10 years, male: female 37:63; 17 patients of diabetes and 83 patients of non-diabetes; Total blood loss was 645.59 ± 376.37 ml, hidden blood loss was 421.39 ± 337.45 ml, the hidden blood loss percentage was 57 ± 26%. Results from the multi-factorial linear regression model: Diabetes (p < 0.05), hypertension (p < 0.05), psoas thickness (p < 0.05) and dorsal extensor group thickness (p < 0.05) were potential risk factors for postoperative hidden blood loss. Conclusion Although minimally invasive hybrid approach is minimally invasive surgery, there is still a significant amount of hidden blood loss. There is a greater risk of blood loss in diabetes, hypertension and preoperative MRI assessment of thickness of the psoas, thickness of the dorsal extensor group.

Comparison of Transforaminal Lumbar Interbody Fusion in the Ambulatory Surgery Center and Traditional Hospital Settings, Part 1: Multi-Center Assessment of Surgical Safety

“…We found similarly rare frequencies between study groups for emergency department visits and hospital re-admissions, with one patient in each group requiring revision surgery with implant removal during the 30 day observation period. This study also confirmed the previous observation of substantially reduced perioperative blood loss associated with minimally-invasive TLIF regardless of setting [ 15 , 16 , 17 , 18 ]. Although there was a statistically significant difference in blood loss between patients treated in the ASC (250 cc) and the traditional hospital setting (100 cc), the average volumes were well within the expected range of reported values for minimally-invasive TLIF of 126 cc to 772 cc [ 15 , 16 , 17 , 18 , 19 ].…”

“…This study also confirmed the previous observation of substantially reduced perioperative blood loss associated with minimally-invasive TLIF regardless of setting [ 15 , 16 , 17 , 18 ]. Although there was a statistically significant difference in blood loss between patients treated in the ASC (250 cc) and the traditional hospital setting (100 cc), the average volumes were well within the expected range of reported values for minimally-invasive TLIF of 126 cc to 772 cc [ 15 , 16 , 17 , 18 , 19 ]. The average blood loss was also substantially less than would be encountered in an open TLIF procedure, which is routinely in excess of 1000 cc [ 20 , 21 ].…”

Comparison of Transforaminal Lumbar Interbody Fusion in the Ambulatory Surgery Center and Traditional Hospital Settings, Part 2: Assessment of Surgical Safety in Medicare Beneficiaries

“…This study noted strikingly similar patient characteristics, procedural efficiency, and the rare occurrence of clinical 30-day safety events between the two study groups. We did observe a significant difference between groups in perioperative blood loss (100 and 200 ccs); however, these volumes were well within the expected range of reported values for minimally invasive TLIF of 126 ccs to 772 ccs [ 28 , 29 , 30 , 31 , 32 ]. The most notable study finding was a marked and statistically significant difference in length of stay favoring patients treated with single-level TLIF in the ASC.…”

Comparison of surgical invasiveness, hidden blood loss, and clinical outcome between unilateral biportal endoscopic and minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease: a retrospective cohort study

“…In a prospective analysis of 114 patients, Smorgick et al [ 32 ]reported substantial HBL during posterior spinal fusion surgery. Many studies have shown that ignoring HBL may not only result in postoperative anaemia not matching perioperative blood loss, but also in medical complications including delayed wound healing, infection, and prolonged hospitalisation [ 10 , 17 ]. Therefore, clarifying HBL allows for a more accurate assessment of TBL.…”