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. 2023 Apr 14;24(1):295.
doi: 10.1186/s12891-023-06393-y.

Comparison of the total and hidden blood loss in patients undergoing single-level open and unilateral biportal endoscopic transforaminal lumbar interbody fusion: a retrospective case control study

Yu-Jian Peng #  1 , Zhi-Ying Fan #  1 , Qian-Liang Wang  1 , Jun Dai  1 , Qian-Zhong-Yi Zhang  1 , Jun-Yin Cao  1 , Xiao-Feng Liu  1 , Jun Yan  2
Affiliations

Comparison of the total and hidden blood loss in patients undergoing single-level open and unilateral biportal endoscopic transforaminal lumbar interbody fusion: a retrospective case control study

Yu-Jian Peng et al. BMC Musculoskelet Disord. .

Abstract

Purpose: This study aimed to compare total blood loss (TBL) and hidden blood loss (HBL) in patients undergoing single-level open transforaminal lumbar interbody fusion (O-TLIF) and unilateral biportal endoscopic transforaminal lumbar interbody fusion (ULIF).

Methods: A total of 53 patients who underwent ULIF and 53 patients who underwent O-TLIF from March 2020 to July 2022 were retrospectively reviewed. The Nadler's formula was employed to estimate the patient's blood volume (PBV), Gross's formula to estimate TBL, and Sehat's formula to estimate HBL. The obtained data were then analyzed with independent t test, chi-squared test, and analysis of covariance.

Results: TBL and measured blood loss (MBL) in ULIF group (326.86 ± 223.45 ml, 99.00 ± 72.81 ml) was significantly lower than O-TLIF group (427.97 ± 280.52 ml, 270.66 ± 102.34 ml). Nevertheless, the HBL in ULIF group was higher than that in O-TLIF group (227.86 ± 221.75 ml vs 157.31 ± 268.08 ml), however this was not statistically significant (p = 0.143). The HBL was 69.71 ± 23.72% of TBL in ULIF group and 36.76 ± 18.79% of TBL in O-TLIF group. Patients in ULIF group had lower TBL and MBL, shorter duration of drainage, lower postoperative anemia, and shorter postoperative hospital stay compared to those in O-TLIF group.

Conclusions: Perioperative HBL should not be neglected in patients undergoing ULIF or O-TILF, as it accounts for a large percentage of TBL in both groups. ULIF is associated with lower TBL and MBL, postoperative anemia, shorter postoperative hospital stays compared with O-TLIF.

Keywords: Degenerative lumbar disease; Hidden blood loss; Total blood loss; Transforaminal lumbar interbody fusion; Unilateral biportal endoscopy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Photographs of the intraoperative scene. A Arrangement of the incisions. ▲A viewing portal.●A working portal. ■Percutaneous pedicle screw. B Intraoperative view of biportal endoscopic spinal surgery
Fig. 2
Fig. 2
Images of the surgical procedure. A An ultrasonic bone scalpel was used for laminectomy and facetectomy. B Flavum ligament was removed by using forceps. C Exposure of disc space. D Pituitary forceps were used for removal of the intervertebral disc material. E Exposure of the disc space. F Endplate preparation. G A cage was filled with bone chips and inserted into the central part of the disc space
Fig. 3
Fig. 3
The propotion of patients with anaemia in 2 groups. Open transforaminal lumbar interbody fusion, O-TLIF; Unilateral biportal endoscopic transforaminal lumbar interbody fusion, ULIF
Fig. 4
Fig. 4
The composition of total blood loss in 2 groups. Open transforaminal lumbar interbody fusion, O-TLIF; Unilateral biportal endoscopic transforaminal lumbar interbody fusion, ULIF; Intraoperative blood loss, IBL; Hidden blood loss, HBL
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References

    1. Heo DH, Son SK, Eum JH, Park CK. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus. 2017;43(2):E8. doi: 10.3171/2017.5.FOCUS17146. - DOI - PubMed
    1. Faldini C, Borghi R, Chehrassan M, Perna F, Pilla F, Traina F. Transforaminal lumbar interbody fusion. Eur Spine J. 2017;26(Suppl 3):429–430. doi: 10.1007/s00586-017-5288-z. - DOI - PubMed
    1. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP. LLIF and ALIF J Spine Surg. 2015;1(1):2–18. doi: 10.3978/j.issn.2414-469X.2015.10.05. - DOI - PMC - PubMed
    1. Zhang Q, Yuan Z, Zhou M, Liu H, Xu Y, Ren Y. A comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion: a literature review and meta-analysis. BMC Musculoskelet Disord. 2014;15:367. doi: 10.1186/1471-2474-15-367. - DOI - PMC - PubMed
    1. Kim JE, Yoo HS, Choi DJ, Park EJ, Jee SM. Comparison of Minimal Invasive Versus Biportal Endoscopic Transforaminal Lumbar Interbody Fusion for Single-level Lumbar Disease. Clin Spine Surg. 2021;34(2):E64–E71. doi: 10.1097/BSD.0000000000001024. - DOI - PMC - PubMed