Neurospine.  2022 Mar;19(1):1-12. 10.14245/ns.2143196.598.

Hemostats in Spine Surgery: Literature Review and Expert Panel Recommendations

Affiliations
  • 1Spine Unit, Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France
  • 2King Saud bin Abdulaziz University for Health Sciences Riyadh, Riyadh, Saudi Arabia
  • 3Department of Orthopaedic Spinal Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  • 4Paris-Versailles Spine Center (Centre Francilien du Dos), Ramsay Santé - Hôpital Privé de Versailles, Versailles, France
  • 5Burjeel Hospital, Abu Dhabi, UAE
  • 6Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid, Spain
  • 7Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
  • 8Department of Orthopaedic Surgery, Hospital Clinico Universitario de Valencia, Valencia, Spain
  • 9Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany
  • 10Department of Neurosurgery, Clinique des Cèdres, Cornebarrieu, France
  • 11G-spine 4, Spine Surgery Division, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
  • 12Triducive Partners Limited, Hertfordshire, UK
  • 13Department of Spine Surgery, Pasteur II Hospital, Centre Hospitalo-Universitaire de Nice, Nice, France

Abstract

Bleeding in spine surgery is a common occurrence but when bleeding is uncontrolled the consequences can be severe due to the potential for spinal cord compression and damage to the central nervous system. There are many factors that influence bleeding during spine surgery including patient factors and those related to the type of surgery and the surgical approach to bleeding. There are a range of methods that can be employed to both reduce the risk of bleeding and achieve hemostasis, one of which is the adjunct use of hemostatic agents. Hemostatic agents are available in a variety of forms and materials and with considerable variation in cost, but specific evidence to support their use in spine surgery is sparse. A literature review was conducted to identify the pre-, peri-, and postsurgical considerations around bleeding in spine surgery. The review generated a set of recommendations that were discussed and ratified by a wider expert group of spine surgeons. The results are intended to provide a practical guide to the selection of hemostats for specific bleeding situations that may be encountered in spine surgery.

Keyword

Spine surgery; Hemostasis; Hemostatics/therapeutic use; Lumbar vertebrae; Cervical vertebrae; Blood loss
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