Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May;33(5):2049-2055.
doi: 10.1007/s00586-024-08184-y. Epub 2024 Mar 13.

Abdominal aortic calcification is an independent predictor of perioperative blood loss in posterior spinal fusion surgery

Ali E Guven  1 , Gisberto Evangelisti  1   2 , Lukas Schönnagel  1   3 , Jiaqi Zhu  4 , Krizia Amoroso  5 , Erika Chiapparelli  1 , Gaston Camino-Willhuber  1 , Soji Tani  1   6 , Thomas Caffard  1   7 , Artine Arzani  1 , Jennifer Shue  1 , Andrew A Sama  1 , Frank P Cammisa  1 , Federico P Girardi  1 , Ellen M Soffin  5 , Alexander P Hughes  8
Affiliations

Abdominal aortic calcification is an independent predictor of perioperative blood loss in posterior spinal fusion surgery

Ali E Guven et al. Eur Spine J. 2024 May.

Abstract

Objective: Abdominal aortic calcification (AAC), often found incidentally on lateral lumbar radiographs, is increasingly recognized for its association with adverse outcomes in spine surgery. As a marker of advanced atherosclerosis affecting cardiovascular dynamics, this study evaluates AAC's impact on perioperative blood loss in posterior spinal fusion (PSF).

Methods: Patients undergoing PSF from March 2016 to July 2023 were included. Estimated blood loss (EBL) and total blood volume (TBV) were calculated. AAC was assessed on lateral lumbar radiographs according to the Kauppila classification. Predictors of the EBL-to-TBV ratio (%EBL/TBV) were examined via univariable and multivariable regression analyses, which adjusted for parameters such as hypertension and aspirin use.

Results: A total of 199 patients (47.2% female) were analyzed. AAC was present in 106 patients (53.3%). AAC independently predicted %EBL/TBV, accounting for an increase in blood loss of 4.46% of TBV (95% CI 1.17-7.74, p = 0.008).

Conclusions: This is the first study to identify AAC as an independent predictor of perioperative blood loss in PSF. In addition to its link to degenerative spinal conditions and adverse postoperative outcomes, the relationship between AAC and increased blood loss warrants attention in patients undergoing PSF.

Keywords: Abdominal aortic calcification; Lumbar spine; Perioperative blood loss; Posterior spinal fusion.

PubMed Disclaimer

References

    1. Smorgick Y, Baker KC, Bachison CC et al (2013) Hidden blood loss during posterior spine fusion surgery. Spine J 13:877–881. https://doi.org/10.1016/j.spinee.2013.02.008 - DOI - PubMed
    1. Wen L, Jin D, Xie W et al (2018) Hidden blood loss in posterior lumbar fusion surgery. Clin Spine Surg 31:180–184. https://doi.org/10.1097/BSD.0000000000000626 - DOI - PubMed
    1. Morcos MW, Jiang F, McIntosh G et al (2018) Predictors of blood transfusion in posterior lumbar spinal fusion. Spine (Phila Pa 1976) 43:E35–E39. https://doi.org/10.1097/BRS.0000000000002115 - DOI - PubMed
    1. Kang T, Park SY, Nam JJ et al (2019) Patient blood management during lumbar spinal fusion surgery. World Neurosurg 130:e566–e572. https://doi.org/10.1016/j.wneu.2019.06.153 - DOI - PubMed
    1. Lei F, Li Z, He W et al (2020) Hidden blood loss and the risk factors after posterior lumbar fusion surgery: a retrospective study. Medicine (United States) 99:E20103. https://doi.org/10.1097/MD.0000000000020103 - DOI

LinkOut - more resources