[Anesthetic considerations for spine surgery in 71 patients with infectious spondylitis: effects of different pathogen either pyogenic or tuberculous on intraoperative blood loss].
BACKGROUND
Little information is available about anesthetic management in spine surgery for infectious spondylitis, in which major bleeding can be expected. The amount of blood loss may vary somewhat with pyogenic or tuberculous spondylitis. Limited data prompted us to get a clue to determine how best to care for these patients.


METHODS
To examine the amount of intraoperative bleeding, 71 patients with either pyogenic (group A; 44 patients) or tuberculous spondylitis (group B; 27 patients) were retrospectively reviewed using hospital records. They underwent posterior fusion with instrumentation and anterior radical resection of the lesion.


RESULTS
No significant differences were observed between the groups in age, gender, comorbidity or length of hospital stay. Operative time was longer in patients with group B (A: 126 +/- 41 vs B: 197 +/- 76 min, P<0.01). There was a trend toward greater blood loss in group B, especially massive bleeding (>1.5 l) occurred at a higher rate (13.6 vs 33.3%, P=0.05). The number of involved vertebrae was more in group B (1.8 +/- 0.9 vs 2.9 +/- 1.3, P<0.01). Both operative time and blood loss volume showed a good correlation with the number of vertebrae infected, suggesting that extensive eradication over several spinal segments may be indicated for tuberculous spondylitis.


CONCLUSIONS
Spine surgery for tuberculous spondylitis is more likely to carry risks of longer operative time and higher rate of blood loss.
Kawamoto
Eiji
E
Department of Anesthesia, Chubu Rosai Hospital, Nagoya 455-8530.
Wakamatsu
Masaki
M
Fujikake
Kazuma
K
Machino
Asami
A
Kaida
Takeshi
T
D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D013166:Spondylitis / Q000382:microbiology* / Q000601:surgery*; D013203:Staphylococcal Infections; D013492:Suppuration; D013997:Time Factors; D014376:Tuberculosis