Hiromitsu Takaoka, Ko Takano, Osamu Matsushige, Seiji Ohtori
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After excluding those on other antiplatelet or anticoagulant therapies, propensity score matching was applied, resulting in two groups of 89 patients each. The study assessed variables such as operative time, intraoperative blood loss, postoperative drain volume, and hemoglobin level changes up to one week post-surgery.</p><p><strong>Results: </strong>The LDA treated group (L group) experienced significantly higher intraoperative blood loss (70.3 ml) compared to the non-LDA treated group (N group) (46.4 ml, P =0.003). Postoperative drain volumes did not differ significantly, but postoperatively, hemoglobin levels decreased by 2.2 g/dL in the L group and by 1.9 g/dL in the N group after one week ( P =0.04). There were no significant differences in the rate of postoperative transfusions or serious bleeding complications between the groups.</p><p><strong>Conclusion: </strong>Although LDA use was associated with increased intraoperative blood loss and a significant drop in postoperative hemoglobin levels, it did not lead to serious bleeding complications. These findings suggest that with careful management, LDA can be safely continued in patients undergoing lumbar decompression surgery. 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引用次数: 0
摘要
研究设计：回顾性临床分析。目的：探讨低剂量阿司匹林（LDA）对脊柱外科围手术期出血及整体安全性的影响。背景资料摘要：对于需要脊柱手术的患者是否继续使用LDA尚无共识。此外，关于LDA对术中和术后出血风险的影响，以往的研究结果并不一致。方法：回顾性队列研究于2014年至2023年在单一机构进行，纳入375例诊断为腰椎管狭窄的患者。其中，98人接受了LDA治疗，207人没有。在排除其他抗血小板或抗凝治疗后，应用倾向评分匹配，产生两组，每组89例患者。该研究评估了手术时间、术中出血量、术后引流量和术后一周血红蛋白水平变化等变量。结果：LDA治疗组（L组）术中出血量（70.3 ml）明显高于非LDA治疗组（N组）（46.4 ml, P =0.003）。术后引流液量差异无统计学意义，但术后1周后，L组血红蛋白水平下降2.2 g/dL， N组血红蛋白水平下降1.9 g/dL （P =0.04）。两组患者术后输血及严重出血并发症发生率无显著差异。结论：虽然LDA的使用与术中出血量增加和术后血红蛋白水平明显下降相关，但并未导致严重的出血并发症。这些结果表明，通过精心管理，LDA可以安全地在腰椎减压手术患者中继续进行。然而，这些结果的普遍性受到研究的观察性质和单中心设计的限制。证据水平：3；
Perioperative Safety of Lumbar Decompression Surgery Performed Under Continuous Low-Dose Aspirin Administration.
Study design: Retrospective clinical analysis.
Objective: To investigate the changes in perioperative bleeding and overall safety associated with the use of low-dose aspirin (LDA) in spinal surgery.
Summary of background data: There is no consensus on whether to continue the use of LDA in patients requiring spinal surgery. Furthermore, previous studies have shown inconsistent results regarding the impact of LDA on the risk of intraoperative and postoperative bleeding.
Methods: A retrospective cohort study was conducted at a single institution from 2014 to 2023, involving 375 patients diagnosed with lumbar spinal stenosis. Of these, 98 were on LDA therapy and 207 were not. After excluding those on other antiplatelet or anticoagulant therapies, propensity score matching was applied, resulting in two groups of 89 patients each. The study assessed variables such as operative time, intraoperative blood loss, postoperative drain volume, and hemoglobin level changes up to one week post-surgery.
Results: The LDA treated group (L group) experienced significantly higher intraoperative blood loss (70.3 ml) compared to the non-LDA treated group (N group) (46.4 ml, P =0.003). Postoperative drain volumes did not differ significantly, but postoperatively, hemoglobin levels decreased by 2.2 g/dL in the L group and by 1.9 g/dL in the N group after one week ( P =0.04). There were no significant differences in the rate of postoperative transfusions or serious bleeding complications between the groups.
Conclusion: Although LDA use was associated with increased intraoperative blood loss and a significant drop in postoperative hemoglobin levels, it did not lead to serious bleeding complications. These findings suggest that with careful management, LDA can be safely continued in patients undergoing lumbar decompression surgery. However, the generalizability of these results is limited by the observational nature of the study and its single-center design.
期刊介绍：
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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