Predictive factors for intraoperative blood loss in surgery for adolescent idiopathic scoliosis

BMC Musculoskelet Disord. 2021 Feb 26;22(1):225. doi: 10.1186/s12891-021-04104-z.


Background: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity. Posterior spinal fusion remains an important surgical treatment for AIS. This study aims to determine the predictive factors for intraoperative blood loss in AIS surgery.

Methods: Patients who had undergone posterior spinal fusion for adolescent idiopathic scoliosis in a single university hospital were reviewed over a 7-year period. Predictive factors for intra-operative blood loss were studied by multivariate analysis to derive a regression model. Receiver operating characteristic analysis was performed to determine the cut-off values of factors contributing to significant intraoperative blood loss (≥500 ml).

Results: Two hundred and twelve patients were included. Intraoperative blood loss was found to be correlated with gender (rs = 0.30 (0.17-0.43)), preoperative hemoglobin level (rs = 0.20 (0.04-0.31)), preoperative Cobb angle (rs = 0.20 (0.02-0.29)), number of fused levels (rs = 0.46 (0.34-0.58)), operation duration (rs = 0.65 (0.54-0.75)), number of anchors (rs = 0.47 (0.35-0.59)), and p-value ranged from < 0.001 to < 0.05. Significant intraoperative blood loss was influenced by the male gender, operation duration greater than 257.5 min and more than 10 anchors used.

Conclusions: Male gender, increased operation duration and higher number of anchors predicted higher intra-operative blood loss.

Keywords: Adolescent idiopathic scoliosis; Blood loss; Predictive factors.

MeSH terms

  • Adolescent
  • Blood Loss, Surgical
  • Humans
  • Kyphosis*
  • Male
  • Retrospective Studies
  • Scoliosis* / diagnostic imaging
  • Scoliosis* / surgery
  • Spinal Fusion* / adverse effects
  • Treatment Outcome