Journal of Spinal Disorders & Techniques最新文献

{"title":"Do you need bone graft extenders for a 2- to 3-level posterior lumbar decompression and fusion with adequate local bone?","authors":"Arya G Varthi, Peter G Whang, Rick C Sasso, Joseph D Smucker","doi":"10.1097/BSD.0000000000000283","DOIUrl":"https://doi.org/10.1097/BSD.0000000000000283","url":null,"abstract":"The standard of care for degenerative pathology of the lumbar spine has undergone a steady evolution over the past 100 years. In the early 20th century, Albee and Hibbs developed noninstrumented posterior spinal fusion techniques to treat patients with tuberculosis of the spine.1 To combat high rates of pseudoarthrosis, Hibbs used iliac crest bone graft to improve fusion rates. Over the past several decades, segmental instrumentation of the spine has been introduced with polyaxial pedicle screw fixation representing the standard of care today. In addition, there has been extensive research focusing on the development of bone graft extenders (BGE), materials which are used to augment the graft volume for spinal fusion procedures. There are several types of BGE that are currently being used for fusion applications including autogenous bone marrow aspirate, demineralized bone matrix, synthetic bone void fillers (eg, hydroxyapatite, calcium sulfate, b-tricalcium phosphate), and recombinant growth factors. Although BGE may be valuable for promoting fusion in patients without adequate local bone, these materials are not typically required for a 2to 3-level posterior decompression and fusion procedure because spinal instrumentation in conjunction with local autograft are both powerful tools that are generally sufficient for achieving a solid arthrodesis. One of the most important factors for obtaining a successful lumbar fusion is proper surgical technique, regardless of the graft material which is employed. In order to prepare a viable fusion bed, the surgeon should be delicate in his handling of the soft tissues during dissection and preserve the local blood supply which provides oxygen, inflammatory cells, as well as hormonal and endocrine mediators that allow for bony healing. Similarly, the technique for harvesting local bone is another important consideration—this should involve a subperiosteal dissection and the full extent of the spinous processes should be harvested as graft so that it may be placed over bony surfaces that are meticulously decorticated to stimulate fusion. Strict adherence to these surgical principles allows the surgeon to preserve the integrity of the soft-tissue envelope and prepare a large fusion bed supplemented with an adequate amount of graft material. To this end, several studies have demonstrated the efficacy of local bone graft for fusion as a treatment of degenerative lumbar pathology. Kho and Chen evaluated the clinical and radiographic outcomes of 136 patients with spondylolisthesis who underwent 2-level posteolateral lumbar fusions with use of local bone and they reported a 94.85% fusion rate 24 months after surgery. Similarly, Lee et al4 assessed 182 patients with degenerative spondylolisthesis who underwent decompression and 2-level instrumented posterolateral fusion with only local bone. After at least 18 months of followup, the authors identified a bilateral fusion mass in 62% of patients, a unilateral fusion i","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 5","pages":"159"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0000000000000283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33313301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero-profile Anchored Spacer Reduces Rate of Dysphagia Compared With ACDF With Anterior Plating.","authors":"Christoph P Hofstetter,&nbsp;Kartik Kesavabhotla,&nbsp;John A Boockvar","doi":"10.1097/BSD.0b013e31828873ed","DOIUrl":"https://doi.org/10.1097/BSD.0b013e31828873ed","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To study clinical and radiologic outcomes after anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer compared with a standard interposition graft with anterior plating.</p><p><strong>Summary of background data: </strong>Anterior plating increases fusion rates in ACDF but is associated with higher rates of postoperative dysphagia. Reduction of plate thickness or zero-profile fixation of the interposition graft have been suggested to decrease the incidence of postoperative dysphagia.</p><p><strong>Methods: </strong>Retrospective cohort study of 70 consecutive patients of whom the first 35 patients underwent ACDF with anterior plating and the remaining patients received an LDR device. Patient demographics, operative details, neurological impairment, complications, and radiographic imaging were reviewed. Dysphagia occurring in the immediate postoperative period and lasting for >3 months was recorded.</p><p><strong>Results: </strong>Both the zero-profile anchored spacer and a standard interposition graft with anterior plating resulted in improvement of neurological outcome at a mean follow-up time of 13.9 months. Fusion rates were found to be similar between ACDF with anterior plating (96.0%) and LDR (95.2%). Evaluation of postoperative radiographs revealed significantly more swelling of the prevertebral space (20.4±0.9 mm) after implantation of an anterior locking plate compared with a zero-profile device (15.6±0.7 mm, P<0.001). This difference remained significant at 6-month follow-up (P=0.035). Seven patients (20%) with ACDF and plating complained about swallowing difficulties beyond 3 months compared with only 1 patient with the LDR device (P=0.027). The severity of dysphagia was mild in all but 2 patients. Both patients with moderate and severe swallowing difficulties had undergone ACDF with anterior plating.</p><p><strong>Conclusions: </strong>Zero-profile anchored spacers lead to similar clinical and radiographic outcomes compared with ACDF with plating and may carry a lower risk of postoperative dysphagia.</p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 5","pages":"E284-90"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0b013e31828873ed","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31255016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BMP-2-induced Neuroforaminal Bone Growth in the Setting of a Minimally Invasive Transforaminal Lumbar Interbody Fusion.","authors":"Junyoung Ahn,&nbsp;Ehsan Tabaraee,&nbsp;Kern Singh","doi":"10.1097/BSD.0000000000000282","DOIUrl":"https://doi.org/10.1097/BSD.0000000000000282","url":null,"abstract":"<p><p>Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has become a popular alternative to traditional methods of lumbar decompression and fusion. When compared with the open technique, the minimally invasive approach can result in decreased pain and blood loss as well as a shorter length of hospitalization. However, the narrower working channel through the tubular retractor increases the difficulty of decortication and bone grafting. Therefore, recombinant human bone morphogenetic proteins (rhBMP-2) is often utilized (although this is off-label) to create a more favorable interbody fusion environment. Recently, the use of rhBMP-2 has been associated with excessive bone growth in an MIS-TLIF. If this bone growth compresses the neighboring neural structures, patients may present with either new or recurrent radicular pain. Computed tomographic (CT) imaging can demonstrate heterotopic bone growth extending from the disk space into either the ipsilateral neuroforamen or lateral recess, which may result in the compression of the exiting or traversing root, respectively. The purpose of this article and the accompanying video is to demonstrate a technique for defining and resecting rhBMP-2-induced heterotopic bone growth following a previous MIS-TLIF. </p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 5","pages":"186-8"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0000000000000282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33187045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BONE GRAFT EXTENDERS ARE NOT NEEDED: LOCAL BONE GRAFT IS SUFFICIENT","authors":"A. Varthi, Peter G. Whang","doi":"10.1097/01.BSD.0000466800.30532.44","DOIUrl":"https://doi.org/10.1097/01.BSD.0000466800.30532.44","url":null,"abstract":"","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 1","pages":"159-160"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.BSD.0000466800.30532.44","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61693513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-Ray-based Kinematic Analysis of Cervical Spine According to Prosthesis Designs: Analysis of the Mobi C, Bryan, PCM, and Prestige LP.","authors":"Sung B Park,&nbsp;Ki J Kim,&nbsp;Yong J Jin,&nbsp;Hyun J Kim,&nbsp;Tae-A Jahng,&nbsp;Chun K Chung","doi":"10.1097/BSD.0b013e318288a923","DOIUrl":"https://doi.org/10.1097/BSD.0b013e318288a923","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>To identify significant kinematic changes in the cervical spine after cervical artificial disk replacement (ADR) using prostheses with diverse designs.</p><p><strong>Summary of background data: </strong>Various types of artificial disks are used for cervical ADR. However, few clinical studies with a follow-up of 2 or more years have reported on the change in the curvatures and range of motion (ROM) of the cervical spine after cervical ADR in relation to different designs.</p><p><strong>Methods: </strong>The cohort comprised 58 patients who underwent single-level cervical ADR for radiculopathy. The patients were divided into 4 groups according to the device they received: Mobi-C, Bryan, PCM, and Prestige LP. The radiographs of the cervical spine were obtained preoperatively and at 12, 24, and 36 months after surgery. Several kinematic parameters, including lordotic angles and ROM of the cervical spine, index level, and superior and inferior adjacent disk levels, were assessed preoperatively and at predefined follow-up time points.</p><p><strong>Results: </strong>Cervical sagittal lordosis in patients who received Bryan and PCM prostheses increased at the last follow-up period. The 4 patient groups showed a trend toward an increase of lordosis in the superior adjacent segment with time. The patients who received the Bryan device lost their preoperative lordotic angle at the inferior adjacent level. The ROM of the cervical spine in patients who received Bryan and PCM prostheses increased at the last follow-up compared with preoperative values. The incidence of adjacent segment degeneration in the Mobi-C, Bryan, Prestige LP, and PCM groups were 14.2%, 25%, 9.0%, and 7.6%, respectively.</p><p><strong>Conclusions: </strong>These results suggest preservation of sagittal ROM and increased superior adjacent segment kinematics, regardless of prosthesis design. Devices with an unconstrained design may not be beneficial to adjacent segment kinematics compared with semiconstrained prostheses.</p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 5","pages":"E291-7"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0b013e318288a923","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31255017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphologic Changes in Contralateral Lumbar Foramen in Unilateral Cantilever Transforaminal Lumbar Interbody Fusion Using Kidney-type Intervertebral Spacers.","authors":"Takahiro Iwata,&nbsp;Kei Miyamoto,&nbsp;Akira Hioki,&nbsp;Kazunari Fushimi,&nbsp;Takatoshi Ohno,&nbsp;Katsuji Shimizu","doi":"10.1097/BSD.0b013e318286bb14","DOIUrl":"https://doi.org/10.1097/BSD.0b013e318286bb14","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study of 58 patients undergoing cantilever transforaminal lumbar interbody fusion (c-TLIF).</p><p><strong>Objectives: </strong>To evaluate morphologic changes in the intervertebral foramen (IVF) on the side contralateral to spacer insertion in patients undergoing c-TLIF using plain x-ray films and computed tomography scan.</p><p><strong>Summary of background data: </strong>The morphologic changes in the contralateral lumbar foramen in c-TLIF using unilateral insertion of spacers have not been well studied.</p><p><strong>Materials and methods: </strong>Fifty-eight consecutive patients with lumbar dysplastic changes or degenerative disk diseases underwent c-TLIF using 96 kidney-type spacers with local bone grafts. Radiographic findings (sagittal disk angle), computed tomography scan findings (coronal disk angle, disk height, foraminal height (FH), foraminal width, and cross-sectional area of IVF in contralateral lumbar foramen) were compared between preoperative period and 6 months after surgery. The correlations between contralateral lumbar foraminal dimensions and disk height, sagittal disk angle, and coronal disk angle were analyzed.</p><p><strong>Results: </strong>After c-TLIF, sagittal angle, disk height, FH, foraminal width, and cross-sectional area of the IVF were significantly increased. Increase in posterior disk height showed a positive correlation with increases in FH, foraminal width, and cross-sectional area of IVF (r=0.235-0.511). However, the increase in sagittal disk angle showed a negative correlation with changes in foraminal width and cross-sectional area of IVF (r=-0.256 to -0.206).</p><p><strong>Conclusions: </strong>Lumbar foraminal dimensions on the side contralateral to spacer insertion increased significantly after c-TLIF, suggesting that c-TLIF enables indirect decompression of the contralateral nerve root. Although increase in posterior disk height was shown to be an important factor to increase contralateral foraminal size, segmental lordosis was a risk factor for a decrease in contralateral foraminal size.</p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 5","pages":"E270-6"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0b013e318286bb14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31214648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LOCAL BONE ONLY: NOT ENOUGH VOLUME, NOT ENOUGH BIOLOGY","authors":"R. Sasso, Joseph D. Smucker","doi":"10.1097/01.BSD.0000466801.68650.E9","DOIUrl":"https://doi.org/10.1097/01.BSD.0000466801.68650.E9","url":null,"abstract":"","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 1","pages":"160-162"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.BSD.0000466801.68650.E9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61693524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between cervical spine pathology and rotator cuff dysfunction.","authors":"Alan L Zhang,&nbsp;Alexander A Theologis,&nbsp;Bobby Tay,&nbsp;Brian T Feeley","doi":"10.1097/BSD.0000000000000223","DOIUrl":"https://doi.org/10.1097/BSD.0000000000000223","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To investigate the relationship between cervical spine (C-spine) and rotator cuff (RTC) pathology.</p><p><strong>Summary of background data: </strong>Cervical spine and RTC pathology cause significant shoulder pain in isolation and in tandem, but there is limited information about the relationship between these 2 entities.</p><p><strong>Methods: </strong>Patients with a diagnosis of C-spine and/or RTC pathology between 2005 and 2011 were identified using a large national database composed of private payer as well as Medicare patient records. Patients with concomitant C-spine and RTC diagnoses were then stratified by age group and sex. Patients with lumbar spine (L-spine) and RTC pathology were used as a comparative group, and multivariate logistic regression was used for statistical analysis.</p><p><strong>Results: </strong>Concomitant C-spine and RTC diagnoses were identified in 86,928 patients representing 13% of 679,112 patients with a RTC diagnosis and 16% of 531,177 patients with a C-spine diagnosis. The association between C-spine and RTC pathology increased significantly with age as RTC diagnoses were present in 13% of patients with C-spine pathology younger than 60 years old but increased to 25% in C-spine patients older than 60 years (P<0.0001). For patients over 60 years old who developed a new C-spine diagnosis, 11% would develop a new RTC diagnosis or undergo an operation for a RTC disorder within 5 years. Lumbar diagnosis codes (2,297,480 patients) were over 4 times more common than C-spine codes but RTC pathology had a significantly higher correlation with C-spine pathology than L-spine pathology (odds ratio, 2.32) and patients with C-spine pathology were more likely to develop new rotator cuff pathology (odds ratio, 1.53).</p><p><strong>Conclusions: </strong>The association between cervical spine and RTC pathology is significantly greater than that between L-spine and RTC pathology and increases substantially with patient age. Further studies are needed to elucidate the cause of this relationship.</p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 4","pages":"E206-11"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0000000000000223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32811721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Modified Kurokawa's Double-Door Laminoplasty Reduce the Incidence of Axial Symptoms at Long-term Follow-up?: A Prospective Study of 152 Patients With Cervical Spondylotic Myelopathy.","authors":"Le Wang,&nbsp;Fuxin Wei,&nbsp;Shaoyu Liu,&nbsp;Yong Wan,&nbsp;Ningning Chen,&nbsp;Shangbin Cui,&nbsp;Rui Zhong,&nbsp;Yangliang Huang","doi":"10.1097/BSD.0000000000000242","DOIUrl":"https://doi.org/10.1097/BSD.0000000000000242","url":null,"abstract":"<p><strong>Study design: </strong>A prospective cohort study.</p><p><strong>Objective: </strong>The purpose of this study was to determine whether the modified procedure reduces long-term axial symptoms (AS) and to understand better why the AS occur.</p><p><strong>Summary of background data: </strong>Following Kurokawa's double-door laminoplasty, postoperative AS reduce the quality of life of patients with cervical spondylotic myelopathy. The etiology of AS remains unclear. Some studies report that preservation of the C7 spinous process can reduce the frequency of AS. The modified Kurokawa procedure prevents AS by preserving the semispinalis cervicis insertion in the spinous process of C2. However, it remains unclear whether the modified procedure lowers the incidence of AS in the long term (ie, >3 y).</p><p><strong>Materials and methods: </strong>This prospective cohort study investigated preoperative and postoperative v, cervical intervertebral range of motion, postoperative neurological recovery, neck disability index, visual analog scale, surgical cost, and time and blood loss.</p><p><strong>Results: </strong>Both groups had satisfied improvement of neurological functions (P>0.05). At 3 months and 1 year after surgery, the difference in frequency between no symptoms and mild/severe symptoms was significant (traditional group, 39.06%; modified group, 20.45%) (P<0.05). Interestingly, 3 years after surgery, there were no significant between-group differences (P>0.05).</p><p><strong>Conclusions: </strong>This modified approach reduced the incidence of postoperative ASs at 3 months and 1 year after the operation; however, the between-group difference was not significantly different at the 3-year follow-up. The reason for this finding is unclear; it may indicate that the incidence of AS is caused by other factors, such as the preservation of the C7 spinous process rather than the C2 spinous process.</p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 4","pages":"E186-93"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0000000000000242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32994608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Data-driven Utilization of Hematologic Labs Following Lumbar Fusion.","authors":"Andrew Y Yew,&nbsp;Haydn Hoffman,&nbsp;Charles Li,&nbsp;Duncan Q McBride,&nbsp;Langston T Holly,&nbsp;Daniel C Lu","doi":"10.1097/BSD.0000000000000194","DOIUrl":"https://doi.org/10.1097/BSD.0000000000000194","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Summary of background data: </strong>Large national inpatient databases estimate that approximately 200,000 lumbar fusions are performed annually in the United States alone. It is common for surgeons to routinely order postoperative hematologic studies to rule out postoperative anemia despite a paucity of data to support routine laboratory utilization.</p><p><strong>Objective: </strong>To describe quantitative criteria to guide postoperative utilization of hematologic laboratory assessments.</p><p><strong>Methods: </strong>A retrospective analysis of 490 consecutive lumbar fusion procedures performed at a single institution by 3 spine surgeons was performed. Inclusion criteria included instrumented and noninstrumented lumbar fusions performed for any etiology. Data were acquired on preoperative and postoperative hematocrit, platelets, and international normalized ratio as well as age, sex, number of levels undergoing operation, indication for surgery, and intraoperative blood loss. Multivariate logistic regression was performed to determine correlation to postoperative transfusion requirement.</p><p><strong>Results: </strong>A total of 490 patients undergoing lumbar fusion were identified. Twenty-five patients (5.1%) required postoperative transfusion. No patients required readmission for anemia or transfusion. Multivariate logistic regression analysis demonstrated that reduced preoperative hematocrit and increased intraoperative blood loss were independent predictors of postoperative transfusion requirement. Intraoperative blood loss >1000 mL had an odds ratio of 8.9 (P=0.013), and preoperative hematocrit <35 had an odds ratio of 4.37 (P=0.008) of requiring a postoperative transfusion.</p><p><strong>Conclusions: </strong>Routine postoperative hematologic studies are not necessary in many patients. High intraoperative blood loss and low preoperative hematocrit were independent predictors of postoperative blood transfusion. Our results describe quantitative preoperative and intraoperative criteria to guide data-driven utilization of postoperative hematologic studies following lumbar fusion.</p>","PeriodicalId":50043,"journal":{"name":"Journal of Spinal Disorders & Techniques","volume":"28 4","pages":"E231-6"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/BSD.0000000000000194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32767582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}