Effects of Discontinuance of Preoperative Anti-Platelet Medication in Multi-Level Thoracolumbar Spine Surgery.

AIM: To evaluate the perioperative morbidities of patients taking anti-platelet medication prior to multi-level thoracolumbar spine surgery. < p < MATERIAL and METHODS: We retrospectively reviewed the medical records of 65 patients who underwent multi-level spine surgery from January 2009 to November 2014 at our institution. These patients were divided into two groups: the control group (n=45) did not take any anti-platelet medications prior to surgery; the anti-platelet group (n=20) discontinued the anti-platelet medication 7 days before the spine surgery. The patients" age, body mass index (BMI), medical history, operation time, and estimated intraoperative blood loss were assessed. The incidence of postoperative major complications, such as spinal epidural hematoma or operative site infection, was also compared.

RESULTS: The overall postoperative complication rates were similar in both groups. The rates of major complications were 5% (1/20) for the anti-platelet group and 8.9% (4/45) for the control group. In the anti-platelet group, one patient experienced surgical site infection, which has no relationship with bleeding tendency. Severe bleeding-related complications in the perioperative period were not observed in either group. Multiple logistic regression analysis demonstrated that cancer history and long hospital stay were independent predictors of operation-related complications. Among intraoperative parameters such as estimated intraoperative blood loss and intraoperative transfusion rates, there were no statistical differences between the groups.

CONCLUSION: Surgical complication-related perioperative bleeding has had a serious influence on surgical outcomes. According to our study, preoperative anti-platelet therapy did not increase bleeding-related complications. Spine operations can be performed relatively safely if the co-morbidities of patients are considered.