title: Efficacy of TachoSil, a Fibrin-Based Hemostat, for Anterior Lumbar Spine Surgery.
abstract: METHODS
  Retrospective case series.
  
  
  OBJECTIVE
  To examine the efficacy of TachoSil for vessel injury in 6 patients who underwent anterior lumbar fusion surgery (ALF).
  
  
  BACKGROUND
  ALF for the lumbar spine has a high rate of success, although intraoperative concerns and iatrogenic complications are known, and injury of a major vessel is sometimes a complication. The efficacy of TachoSil, a fibrin-based hemostat, has been reported for several types of surgery; however, use of TachoSil for ALF surgery has not been described. Here, we report on the efficacy of TachoSil in 6 patients, who underwent ALF after vascular surgeons having difficulty in repairing vessels.
  
  
  METHODS
  Two man and 4 women with average age of 50.8±10.9 (mean±standard deviation) were diagnosed with a vertebral tumor (2 patients), L4 degenerative spondylolisthesis (2 patients), and L5 spondylolytic spondylolisthesis (2 patients) and underwent ALF. The blood vessels injured included the common iliac vein in 2 patients and a branch of a segmental artery from the aorta in 4 patients. We consulted a vascular surgeon to suture or repair the vessels during surgery, and although the vascular surgeon attempted to address the injuries, suturing or repair was not possible in these cases. For this reason, we used TachoSil to repair the injury in the vessels walls or to stop the bleeding.
  
  
  RESULTS
  Time to pressure hemostasis using TachoSil was 34±12 minutes, and total blood loss was 1,488±1,711 mL. Nevertheless, all vessel injuries were controlled by the use of TachoSil.
  
  
  CONCLUSIONS
  We recommend the use of TachoSil for vessel injuries that vascular surgeons cannot suture or repair during ALF surgery.
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Jo
authors: J
authors: Watanabe
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Seiji
authors: S
authors: Ohtori
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Sumihisa
authors: S
authors: Orita
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Kazuyo
authors: K
authors: Yamauchi
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Yawara
authors: Y
authors: Eguchi
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Yasuchika
authors: Y
authors: Aoki
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Junichi
authors: J
authors: Nakamura
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Miyako
authors: M
authors: Suzuki
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Kazuhide
authors: K
authors: Inage
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Jun
authors: J
authors: Sato
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Yasuhiro
authors: Y
authors: Shiga
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Koki
authors: K
authors: Abe
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Kazuki
authors: K
authors: Fujimoto
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Hirohito
authors: H
authors: Kanamoto
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Eiji
authors: E
authors: Hanaoka
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Kazuhisa
authors: K
authors: Takahashi
keywords: A fibrin-based hemostat; Anterior lumbar fusion surgery; Blood; TachoSil