Utilization of Autogenous Blood Products for Spine Surgery

Todd W. Vitaz, MD
Claire Meena–Leist, MD (Louisville, KY)

Introduction:

The use of autogenous blood products in spine surgery has increased over the past decade. This is related to concerns regarding transmittable infectious diseases associated with blood transfusion. However, such procedures tend to be costly because of the high overhead associated with collection and storage and low utilization rates.

Method:

We retrospectively reviewed the utilization of autogenous blood products for all thoracic and lumbar spine procedures conducted at Norton Hospital (Louisville, KY) between October 1, 1998 and December 31, 1998.

Results:

Autogenous blood was collected for 91 surgical procedures (5 posterior decompressions, 51 posterior decompressions with fusion instrumentation, 4 anterior fusions, 21 posterior fusions, and 8 combined anterior and posterior approaches). A total of 197 units of directed donor blood were collected with subsequent transfusion of 59 (29.9%) units. Utilization of autogenous blood products was lowest for simple decompressions (11%) and highest for combined anterior and posterior approaches (52.9%). Procedures involving greater than two levels had a utilization rate of 61.8% compared with 32.1% for two level, and 18.7% for one level procedures.

Conclusion:

The use of autogenous blood products is useful for selected thoracic and lumbar spine procedures (multi–level or combination approaches). However, the use of such products during low risk procedures (single level posterior decompressions) must be evaluated on an individual basis. Finally, less expensive alternatives such as intraoperative blood salvage should be considered in cases where excessive blood loss in not anticipated.