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Bloodless Spine Surgery

  1. What is bloodless surgery?
      Surgery that results in little to no blood loss.
  2. What are the benefits of having minimal blood loss during surgery?
      Quicker recovery and decreased hospital stay.
  3. What causes blood loss during spine surgery?
      Bone bleeds since it is highly vascularized and this is what causes most bleeding. Bleeding can also occur to do muscle dissection since they are rich in arterial supply. Bleeding can come from direct trauma to major vessels in an anterior approach.
  4. How much blood is “normal” to loose and/or be replaced during spine surgery?
      I believe that minimal to no blood loss should be the standard.
  5. What percentage of spine surgeries require a blood transfusion?
      In my practice the percentage is low.
  6. What percentage of bloodless spine surgeries requires a blood transfusion?
      Possible seroma, unhooking of the rods, muscle spasm
  7. What surgical methods, techniques, or precautions are used to prevent blood loss?
      Careful muscle dissection, use of instruments whose sharp edges are protected from causing damage. Experience with mobilizing major vessels.
  8. Are there specific regions of the spine that are more vulnerable to blood loss? (Cervical vs. Thoracic vs. Lumbar vs. Sacrum etc.)
      Depends on what surgical technique you are using.
  9. Are there specific procedures that are more vulnerable to blood loss?(Removing a tumor, disc herniation, Stenosis, etc.)
      Ones that involve removal of bone, such as corpectomies and that involved tumors.
  10. How does muscle stripping affect blood loss? Can this be mitigated or prevented?
      It can increase blood loss and it should be avoided, by separating the muscle at its origin.
  11. Does osteotomy or fusion have an effect on blood loss?
      Osteotomy can increase blood loss.
  12. Are there specific considerations for scoliosis?
      Dealing with a large surface area.
  13. Does bloodless spine surgery have any affect on paraplegia?
      Minimizing blood loss will prevent complications.
  14. Is autologous blood donation recommended for bloodless surgeries?
      Not in my practice
  15. How are robotic arms being used to prevent blood loss during surgery?
      Do not use them
  16. Are there certain groups (Pregnant Women, Jehovah’s Witness, Asian American, etc) who specifically request bloodless procedures?
      Jehovah’s Witness for religious preferences.

What is your opinion on injecting any liquid into the spine for pain relief instead of steroids?

Can you please comment on this article which talks about back pain steroids.

It can be used initially to gauge the patients response to injections and may provide some relief but will not fix the problem.