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Coagulopathies associated with major spinal surgery.
1Department of Orthopedic Surgery, West Virginia University, Morgantown 26506.
Clinical Orthopaedics and Related Research
|August 1, 1989
Summary
Coagulation disorders, including disseminated intravascular coagulation (DIC), can occur during major spinal surgery. Monitoring coagulation and using cryoprecipitate for fibrinogen replacement are crucial for managing bleeding risks.
Area of Science:
- Neurosurgery
- Hematology
- Anesthesiology
Background:
- Coagulation disorders may be underestimated in major spinal surgery.
- Disseminated intravascular coagulation (DIC) represents a severe manifestation of these disorders.
Observation:
- The development of coagulopathy is independent of patient age or the cause of spinal deformity.
- Acute bleeding diathesis can occur intraoperatively or postoperatively and prove challenging to control.
Findings:
- Consumptive coagulopathy during spinal surgery is not self-limiting.
- Pre-, intra-, and postoperative coagulation monitoring can identify patients at risk for DIC.
- Prompt therapeutic intervention is essential for managing these patients.
Implications:
- Identifying at-risk patients allows for timely management of bleeding complications.
- Cryoprecipitate is the preferred treatment for fibrinogen replacement in cases of active hemorrhage or transfusion intolerance.
- Enhanced monitoring protocols can improve patient outcomes in complex spinal surgeries.