Original Article

European Spine Journal

, Volume 21, Issue 12, pp 2659-2663

The effect of omega-3 fatty-acid supplements on perioperative bleeding following posterior spinal arthrodesis

  • Dennis S. MeredithAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery Email author 
  • , Christopher K. KeplerAffiliated withDepartment of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University
  • , Brandon HirschAffiliated withDepartment of Orthopedic Surgery, University of Miami
  • , Joseph NguyenAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery
  • , James C. FarmerAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery
  • , Federico P. GirardiAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery
  • , Patrick F. O’LearyAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery
  • , Frank P. CammisaAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery

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Abstract

Purpose

To investigate the effect of omega-3 fatty-acid supplements (n-3FA) on bleeding during posterior spinal arthrodesis.

Methods

We reviewed all one- or two-level posterolateral lumbar decompression/fusions with or without interbody fusion by five surgeons within 3 years. Patients taking n-3FA preoperatively were matched 1:2 with controls based on procedure, surgeon and operative time. Patients with abnormal coagulation parameters, known bleeding disorders or other medications that could affect surgical blood loss were excluded.

Results

Twenty-eight patients met inclusion criteria. The n-3FA and control groups were similar with respect to gender, age, body mass index, operative time, and preoperative use of non-steroidal anti-inflammatory drugs. The n-3FAs were stopped an average of 5.2 days before surgery (range 1–10). Mean estimated blood loss (EBL) was 697 ml in the n-3FA group and 771 ml in the control group (p = 0.36). Mean transfused volume of Cell Saver (CS) was 282 ml in the n-3FA group and 321 ml in the control group (p = 0.30). A post hoc power analysis showed that the study was powered to detect a minimum difference of 105 ml for EBL and 50 ml for CS. The multivariate generalized estimating equation did not show a significant difference between groups for EBL or CS (p = 0.35 and p = 0.29, respectively). Secondary outcomes including drop in postoperative hemoglobin, transfusion requirement, complications and surgical drain output were similar between the two groups.

Conclusions

The n-3FA use did not contribute to higher perioperative blood loss during spinal arthrodesis.

Keywords

Omega-3 fatty acids Bleeding Spinal arthrodesis