Research

Purpose: Operative blood loss in Cerebral Palsy spinal fusions can be large, and the question arises whether larger blood loss affects immediate surgical outcome (length of stay and chance of complications).
Methods: A retrospective chart and x-ray review was performed on all cerebral palsy spinal fusions performed between 1/1/80 and 12/31/95. One hundred and sixty six patients were included of whom 105 underwent a posterior spinal fusion (PSF) alone, 49 a staged anterior/posterior fusion (SAP), and 12 a same day anterior/posterior fusion (SDAP). The blood loss was expressed as the total intra and post-operative loss in cc (EBL) and was also calculated as related to the circulatory blood volume (EBVC), 100% loss equaling one circulating blood volume.
Results: Blood loss varied by the type of procedure and patient weight (p<0.05). A trend towards increasing complications with increased blood loss was noted, but this was not statistically significant. The length of stay was greatest with staged procedures, the earlier years of the study and the presence and number of complications, but was not related to the blood loss expressed as EBL or EBVC.
Conclusion: Blood loss in Cerebral Palsy spinal fusion surgery can be large, as much as three to four times the circulating blood volume, but does not affect the length of stay or complication rate.