Impact of vertebroplasty on blood loss of separation surgery for spinal metastasis

English Keywords:Spinal metastasis  Vertebroplasty  Separation surgery  Intraoperative blood loss

English Abstract:

  【Abstract】 Objectives: To evaluate the impact of vertebroplasty on the blood loss during and after separation surgery for thoracolumbar metastasis. Methods: A total of 40 patients with single segment thoracolumbar metastases were divided into two groups of vertebroplasty group and control group. The vertebroplasty group(n=20) consisted of 12 males and 8 females, aged 45 to 68(average of 56.3±7.5) years old; The control group(n=20) consisted of 11 males and 9 females, aged from 45 to 70(average of 56.8±8.2) years old. All the patients underwent posterior separation surgery, except vertebroplasty group received vertebroplasty after screw placement. There was no significant difference between the two groups of patients in age, gender ratio, primary tumor, location of metastasis, Weinstein-Boriani-Biagini(WBB) classification, Tomita classification and score, main symptoms, and visual analogue scale(VAS) score(P>0.05). The operatiove time, intraoperative blood loss, intraoperative blood transfusion, intraoperative fluid transfusion, postoperative drainage volume, and erythrocyte parameters were compared between the two groups. Results: The vertebroplasty group was significantly less than the control group in intraoperative blood loss(650.0±38.73mL vs 1139.0±57.17mL), blood transfusion(430.0±31.7mL vs 810.0±48.6mL), fluid transfusion(3080.0±769.6mL vs 3800.5±938.7mL), and postoperative drainage volume(501.5±355.5mL and 695.5±384.9mL)(P<0.05). The operative time of the two groups were not significantly different(197.7±31.10min vs 207.7±43.9min, P=0.411). There was no significant difference between the two groups in preoperative hemoglobin, red blood cell count and hematocrit(HCT)(P>0.05), which were decreased significantly after surgery. And the HCT of vertebroplasty group were higher than that in the control group[(36.40±4.89)% vs (30.46±5.49)%, P=0.001]. Conclusions: Vertebroplasty in separation surgery of thoracolumbar metastasis can significantly reduce the intraoperative blood loss, fluid transfusion, and blood transfusion, as well as the postoperative drainage volume, without time extension.