Turkish Neurosurgery
Effects of discontinuance of preoperative anti-platelet medication in multi-level thoracolumbar spine surgery
Jun Seok Lee1, Dong Wuk Son1, Soon Ki Sung1, Sang Weon Lee1, Geun Sung Song1
1Pusan National University Yangsan Hospital, Department of Neurosurgery, Yangsan,
DOI: 10.5137/1019-5149.JTN.18306-16.1

Aim:Our study aimed to evaluate the perioperative morbidities of patients taking anti-platelet medication prior to multi-level thoracolumbar spine surgery. Material and Methods:We retrospectively reviewed the medical records of 65 patients who underwent multi-level spine surgery from January 2009 to November 2014 at our institution. These patients were divided into two groups: the control group (n=45) did not take any anti-platelet medications prior to surgery; the anti-platelet group (n=20) discontinued the anti-platelet medication 7 days before the spine surgery. The patients’ age, BMI, medical history, operation time, estimated intraoperative blood loss and hematologic data were assessed. The incidence of postoperative major complications, such as spinal epidural hematoma or operative site infection, was also compared.Results:: The overall postoperative complication rates were similar in both groups. The incidences of major complication rates were 5% (1/20) for the anti-platelet group and 8.9% (4/45) for the control group. In the anti-platelet group, one patient experienced surgical site infection, which has no relationship with bleeding tendency. Severe bleeding-related complications were not observed in both groups. Multiple logistic regression analysis demonstrated that cancer history and long hospital stay are independent predictors of operation-related complications. In intraoperative parameters such as estimated intraoperative blood loss and intraoperative transfusion rates, there were no statistical differences between the groups.Conclusion:Surgical complication-related perioperative bleeding has had serious influences on surgical outcomes. According to our study, preoperative anti-platelet therapy did not increase bleeding-related complications. Spine operations can be performed relatively safely if the comorbidities of patients are considered.

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