Related Experiment Video
Updated: May 28, 2026
04:19
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Risk Factors for Massive Intraoperative Blood Loss During Posterior Spinal Instrumentation and Fusion in Children: A
Shanshan Zhang1, Zhengzheng Gao1, Jing Hu1
1Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Children (Basel, Switzerland)
|May 27, 2026
Summary
Younger age, heart disease, more fused levels, and longer surgery increase massive blood loss risk in pediatric scoliosis patients undergoing posterior spinal instrumentation and fusion (PSIF). This can lead to longer hospital stays and more transfusions.
Area of Science:
- Pediatric Orthopedics
- Spine Surgery
- Scoliosis Management
Background:
- Massive blood loss during posterior spinal instrumentation and fusion (PSIF) is a concern in pediatric scoliosis surgery.
- Identifying risk factors and prognostic implications is crucial for patient safety and optimizing surgical outcomes.
Purpose of the Study:
- To investigate independent risk factors for massive intraoperative blood loss in pediatric patients undergoing PSIF for scoliosis.
- To explore the prognostic implications of massive blood loss in this patient population.
Main Methods:
- Retrospective analysis of 460 pediatric patients who underwent PSIF between June 2021 and January 2024.
- Patients were categorized based on intraoperative blood loss: massive (estimated blood loss/estimated blood volume ≥ 30%) vs. nonmassive.
- Multivariate logistic regression was used to identify independent risk factors for massive blood loss.
Main Results:
- Massive intraoperative blood loss occurred in 27% of patients.
- Independent risk factors for massive blood loss included younger age (OR=0.829), history of heart disease (OR=4.338), greater number of fused levels (OR=1.118), and longer operative time (OR=1.008).
- The massive blood loss group experienced longer postoperative hospital stays and a higher rate of allogeneic blood transfusion.
Conclusions:
- Younger age, pre-existing heart disease, increased number of fused spinal levels, and prolonged operative duration are significant independent risk factors for massive intraoperative blood loss.
- These findings highlight the need for careful preoperative assessment and intraoperative management in pediatric scoliosis patients undergoing PSIF, especially those with identified risk factors.
