Our Summary

This study explored factors that can contribute to hidden blood loss during a specific type of minimally invasive spine surgery called lumbar interbody fusion, which is commonly used to treat spine diseases. The researchers collected and analyzed data from 100 patients who had this operation. They found that patients with diabetes and hypertension, or those who had thicker back muscles and a thicker ‘psoas’ (a major muscle in the body) detected in their pre-surgery MRI scans, were more likely to experience hidden blood loss during the surgery. This is crucial to know because while the surgery is considered minimally invasive, it can still result in a significant amount of hidden blood loss.

FAQs

  1. What factors can contribute to hidden blood loss during lumbar interbody fusion surgery?
  2. Are patients with certain pre-existing conditions more likely to experience hidden blood loss during lumbar interbody fusion surgery?
  3. How can pre-surgery MRI scans help predict the risk of hidden blood loss during lumbar interbody fusion surgery?

Doctor’s Tip

One helpful tip a doctor might give to a patient about lumbar fusion is to closely monitor and manage any underlying health conditions such as diabetes and hypertension before undergoing the surgery. Maintaining good control of these conditions can help reduce the risk of hidden blood loss during the procedure. Additionally, staying active and maintaining a healthy weight can also help optimize outcomes and recovery after lumbar fusion surgery. It is important to follow your doctor’s recommendations and attend all follow-up appointments to ensure a successful recovery.

Suitable For

Patients who are typically recommended for lumbar fusion surgery are those who have:

  • Severe back pain or leg pain that has not improved with conservative treatments such as physical therapy or medication
  • Degenerative disc disease
  • Spinal stenosis
  • Spondylolisthesis
  • Herniated discs
  • Fractures or instability in the spine

Additionally, patients who have certain medical conditions such as diabetes or hypertension, or those with thicker back muscles and a thicker ‘psoas’ muscle, may be at a higher risk for hidden blood loss during lumbar fusion surgery. It is important for healthcare providers to carefully evaluate each patient’s individual risk factors before recommending this type of surgery.

Timeline

Before lumbar fusion:

  1. Patient undergoes initial consultation with a spine specialist to discuss symptoms and determine if surgery is necessary.
  2. Pre-surgical testing, such as blood work, imaging scans (X-rays, MRI), and possibly physical therapy, to assess the extent of the spine condition and overall health.
  3. Patient may undergo a pre-operative clearance by other medical specialists to ensure they are healthy enough for surgery.
  4. Patient receives instructions on how to prepare for surgery, such as fasting before the procedure and stopping certain medications.
  5. Day of surgery, patient is admitted to the hospital or surgical center and undergoes lumbar fusion under general anesthesia.

After lumbar fusion:

  1. Patient wakes up in the recovery room and is monitored for any immediate complications.
  2. Patient is typically discharged from the hospital within a few days and given instructions for at-home care, such as wound care, pain management, and activity restrictions.
  3. Patient may need to attend follow-up appointments with the surgeon to monitor healing progress and address any concerns.
  4. Physical therapy or rehabilitation may be recommended to help the patient regain strength and mobility in the spine.
  5. Over the following weeks and months, patient gradually resumes normal activities and monitors for any signs of complications, such as infection or delayed healing.
  6. Long-term follow-up appointments may be scheduled to assess the success of the surgery and address any lingering symptoms.

What to Ask Your Doctor

  1. What is lumbar fusion and why is it recommended for my specific condition?
  2. What are the potential risks and complications associated with lumbar fusion surgery?
  3. How long is the recovery process after lumbar fusion surgery?
  4. Will I need physical therapy after the surgery and for how long?
  5. What type of pain management can I expect after the surgery?
  6. Are there any restrictions on activities or movements I should be aware of after the surgery?
  7. How often will I need follow-up appointments to monitor my progress?
  8. What are the long-term outcomes and success rates of lumbar fusion surgery for patients with my condition?
  9. Are there any specific factors, such as diabetes or hypertension, that may increase the risk of hidden blood loss during the surgery?
  10. How will my pre-surgery MRI scans be used to assess any potential risks or complications during the surgery?

Reference

Authors: Dai Z, Feng DP, Wu KL, Zhu JY, Li ZW. Journal: BMC Musculoskelet Disord. 2022 Dec 15;23(1):1099. doi: 10.1186/s12891-022-06079-x. PMID: 36522729