Blood Loss of Posterior Lumbar Interbody Fusion on Lumbar Stenosis in Patients With Rheumatoid Arthritis

作者：Shuai Xu, Yan Liang, Jing Wang, Guanjie Yu, Chen Guo, Zhenqi Zhu, Haiying Liu · 发表于：Spine · 年份：2019 · DOI：10.1097/brs.0000000000003037 · 被引用次数：23 · 研究领域：Spine and Intervertebral Disc Pathology、Spinal Hematomas and Complications、Blood transfusion and management

STUDY DESIGN: Case-control study. OBJECTIVE: To compare intraoperative bleeding, drainage, and hidden blood loss (HBL) of posterior lumbar interbody fusion (PLIF) on lumbar spinal stenosis (LSS) in patients with rheumatoid arthritis (RA) and non-RA and identify the risk factors of HBL with RA. SUMMARY OF BACKGROUND DATA: Exploration on PLIF on LSS and HBL has been reported before while the comparison on total blood loss (TBL), especially HBL of PLIF or PLF on LSS between patients with RA and without RA has not been studied. METHODS: Sixty-one patients diagnosed LSS with RA (RA group) and 87 matched patients without RA (NRA group) were enrolled and demographic characteristics, RA-related parameters, operation and blood loss information were extracted. Intraoperative blood loss, drainage, and HBL were primary outcomes and secondary measures included operation time, hematocrit (Hct) and hemoglobin (Hb), the number of anemia and blood transfusion. RESULTS: There was no statistical difference in total blood loss (TBL), intraoperative blood loss, and postoperative drainage while HBL and the proportion of HBL in TBL were lower in NRA group (P < 0.001 and P = 0.012, respectively). Stratified analysis based on the number of surgical levels suggested HBL and the proportion of HBL in NRA group was superior in long-segment surgery (>2 segments). The secondary outcomes showed the change of Hct was lower in NRA group (P = 0.021) but not the reduction of Hb. In addition, there was no signif...