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KMID : 0387720120230030224
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Korean Journal of Blood Transfusion
2012 Volume.23 No. 3 p.224 ~ p.235
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An Experience of Blood Transfusion by Difference of the Count of Fusion Segments in Lumbosacral Spinal Fusion
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Huh Ji-Soon
Yang Tae-Ki
Chung You-Nam
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Abstract
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Background: A large amount of blood is lost during spinal fusion surgery; therefore, a blood transfusion is
required. In this study, we analyzed the amount of transfusion and hemodynamic changes in relation to the count
of fusion segments in lumbosacral spinal surgeries.
Methods: We analyzed 67 patients who had undergone lumbosacral fusion. They were divided into five groups
according to the levels of fusion segments (one level: Group 1, two levels: Group 2, three levels: Group 3, four
levels: Group 4 and above three levels: Groups 3＋4). Total amounts of transfusion and perioperative hemodynamic
changes were compared among each group.
Results: Of the total 67 cases, 40 cases were Group 1, 19 cases were Group 2, five cases were Group 3, three
cases were Group 4, and eight cases were Groups 3＋4. Average volume of Red Blood Cell (RBC) transfusion
per operation was 703±463 mL (Group 1), 934±372 mL (Group 2), 1,677±847 mL (Group 3), 1,231±412 mL
(Group 4), and 1,509±669 mL (Group 3＋4); and average volume of fresh frozen plasma (FFP) per operation
was 55±141 mL (Group 1), 108±181 mL (Group 2), 306±368 mL (Group 3), 567±260 mL (Group 4), and 404±317
mL (Groups 3＋4). Eight patients received transfusion of Platelet Concentrate (PC); each patient received 10 units
(400 mL). The preoperative mean level of hemoglobin and platelet was 13.62±1.47 g/dL and 245±60×103/μL,
postoperatively, 10.26±1.14 g/dL and 150±46×103/μL.
Conclusion: As the fusion segments increase, the need for transfusion of RBC, FFP, and PC increases. Application
of the Maximum Surgical Blood Order Schedule (MSBOS) system is required in the planning of spinal fusion,
especially in multiple segments.
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KEYWORD
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Blood transfusion, Lumbosacral region, Spinal fusion
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