A new study published in the Journal of Bone and Joint Surgery examines the coagulation profile for adolescent idiopathic scoliosis patients who have posterior spinal fusions.
The study authors conducted a prospective, observational study of 58 patients examining their coagulation profile. The adolescent idiopathic scoliosis patients who were otherwise healthy — didn't have bleeding abnormalities — were analyzed when they underwent posterior spinal fusions.
The study found:
1. Nearly half — 47 percent — of the patients received blood products and the average estimated blood loss was 645 mL. The average levels fused was 11.1 levels.
2. There was a mild prothrombin time and partial thromboplastin time increase among the patients, but the overall laboratory values were stable during the surgery.
3. The patients reported an accelerated clot formation, the researchers found in a thromboelastogram analysis and a "slight increase in clot lysis." There was an increase in lysis percentage at 30 minutes, according to the report.
4. The fibrinolysis score was reported as predictive of transfusion and greater blood loss per level. The researchers compiled the fibrinolysis score from the fibrin degradation product presence, D-dimers presence and increase in prothrombin time, which rose steadily throughout the surgery.
5. The study authors concluded, "Over the first two hours of a surgical procedure, varying degrees of fibrinolysis develop. Platelets and coagulation factors are not depleted. Our data support the use of antifibrinolytic therapy for patients with adolescent idiopathic scores."