Related Experiment Video
Updated: Sep 26, 2025
Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion
Published on: June 16, 2023
The effect of low preoperative platelet count on adverse outcomes following lumbar microdiscectomy
Stephan Aynaszyan1, Idorenyin F Udoeyo2, Edward M DelSole1,2
1Geisinger Commonwealth School of Medicine, 525 Pine St., Scranton, PA, 18510, USA.
Background:
Low preoperative platelet count, or thrombocytopenia, has previously been associated with increased complications in elective spine surgeries. No other study has investigated the effects of abnormal coagulation profiles on postoperative outcomes specific to lumbar microdiscectomy (MLD) using a propensity matched cohort.
Methods:
Patient data was retrospectively retrieved from the National Surgical Quality Improvement Program database using Current Procedural Terminology (CPT) code 63030 to isolate patients who solely underwent MLD. Data was collected from 2010 to 2019 and included preoperative, perioperative, and 30-day postoperative variables. Patients were grouped into four platelet categories for ANOVA analysis and pairwise comparisons: Severe Thrombocytopenia (≤100), Thrombocytopenia (101-150), Moderate (151-199), and Normal (200-450). Variables that were significant in the univariate analysis were used in the multivariate analysis to determine the likelihood of experiencing adverse postoperative events - unplanned return to the operating room and surgical site infection. A propensity matched analysis was performed to control for confounding variables.
Results:
A total of 64,747 patients were identified within the 10-year period. The results of the multivariate analysis and the propensity matched analysis showed no significant differences in low preoperative platelet count as an independent predictor of experiencing a return to the operating room or surgical site infection. Furthermore, patients who had diabetes, history of smoking, or had emergency cases were associated with a high likelihood of experiencing these negative adverse events.
Conclusion:
Thrombocytopenia does not appear to independently predict return to the operating room or postoperative infection following MLD. Proper preoperative management strategies should be implemented to monitor comorbidity burden which would otherwise influence adverse outcomes in patients with thrombocytopenia undergoing MLD.
Insights
Low preoperative platelet counts (thrombocytopenia) do not independently predict complications after lumbar microdiscectomy. However, comorbidities like diabetes and smoking increase risks for adverse events in these patients.
Area of Science:
- Neurosurgery
- Hematology
- Surgical Outcomes Research
Background:
- Low preoperative platelet count (thrombocytopenia) is linked to surgical complications.
- Previous research has not specifically examined thrombocytopenia's impact on lumbar microdiscectomy (MLD) outcomes.
- This study investigates abnormal coagulation profiles in MLD patients.
Purpose of the Study:
- To determine if low preoperative platelet count independently predicts adverse postoperative outcomes after MLD.
- To identify factors associated with increased risk of return to the operating room or surgical site infection post-MLD.
Main Methods:
- Retrospective analysis of 64,747 patients undergoing MLD (CPT code 63030) from 2010-2019.
- Patients categorized into four platelet count groups for analysis.
- Multivariate and propensity matched analyses used to assess predictors of adverse events (return to OR, surgical site infection).
Main Results:
- Low preoperative platelet count was not a significant independent predictor of return to the operating room or surgical site infection.
- Diabetes, smoking history, and emergency case status were associated with higher likelihood of adverse events.
- No significant differences in adverse outcomes were found based on preoperative platelet levels.
Conclusions:
- Thrombocytopenia does not appear to independently predict return to the operating room or postoperative infection following MLD.
- Preoperative management should focus on comorbidity burden to mitigate risks in MLD patients.
- Adverse outcomes in thrombocytopenic patients undergoing MLD are influenced by other factors.
