Role of intraoperative red cell salvage and autologus transfusion in metastatic spine surgery: a pilot study and review of literature.
METHODS
Prospective cohort study.


OBJECTIVE
There has been no research examining the use of intraoperative cell salvage during metastatic spinal surgery. The present work is a pilot study investigating the role of cell salvage during metastatic spine surgery.


BACKGROUND
There is no spinal literature about role of cell salvage and autologus transfusion in metastatic spinal cancer.


METHODS
Sixteen spinal metastases patients who received red cell salvage using a leucocyte depletion filter were enrolled. Of these, ten patients who received salvaged blood transfusion were included in the final analysis. Data collection involved looking at the case notes, operating room records and the prospectively updated metastatic spinal cancer database maintained in the spinal department. Cell salvage data was recovered from the central cell salvage database maintained in the anesthetic department.


RESULTS
Amount of salvaged blood ranged from 120 to 600 mL (average, 318 mL). The average drop in hemoglobin was 1.65 units (range, 0.4-2.7 units). Three patients (30%) required postoperative allogenic blood transfusion. The average follow up was 9.5 months (range, 6-6 months). One patient developed new lung metastasis, at seven months. No patient developed new liver metastases. Preoperatively, six patients had diffuse skeletal metastases. Of this subgroup, three developed new skeletal metastases. No cases showed any wound related problems in the postoperative period.


CONCLUSIONS
In our study transfusion of intraoperatively salvaged blood did not result in disseminated metastatic cancer. We would suggest that red cell salvage might have a role during metastatic spine surgery.
Department of Trauma and Orthopaedics, Royal Derby Hospital, Derby, UK.
Harinder
H
Gakhar
Munzer
M
Bagouri
Rajendranath
R
Bommireddy
Zdenek
Z
Klezl
Operative blood salvage; Spinal cord compression