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Hidden blood loss and its risk factors in percutaneous vertebroplasty surgery for osteoporotic vertebral compression fractures

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objectives

Percutaneous vertebroplasty (PVP) is a percutaneous interventional procedure for osteoporotic vertebral compression fractures (OVCFs). However, hidden blood loss (HBL) during the surgery is easily disregarded. This study aimed to evaluate HBL and its possible risk factors in the patients following PVP for OVCFs.

Methods

Patients with OVCFs who underwent PVP surgery between January 2019 and November 2022 at our hospital were retrospectively analyzed. Patients’ demographics, laboratory data, and imaging and clinical date were also collected. Preoperative and postoperative hematocrit were recorded, the hidden blood loss was calculated according to Sehat formula, and the risk factors were analyzed by multivariate linear regression analysis.

Results

One hundred and fifty-five patients (26 males and 129 females) were retrospectively enrolled in this study. 85.2% of patients had one segment vertebral fracture and the mean surgical time was 30.5 ± 11.0 min. No intraspinal cement leakage occurred. The mean HBL was 204.0 ± 89.6 ml. Multivariate linear regression analysis revealed that HBL was positively associated with number of fracture segments (P = 0.001), degree of vertebral height restoration (P = 0.001), surgical time (P = 0.000), number of puncture (P = 0.002), and cement leakage (P = 0.038).

Conclusions

Multiple vertebral fractures, higher degree of vertebral height restoration, longer surgical time, more number of puncture, and cement leakage are independent risk factors for HBL. Therefore, HBL should not be neglected in the patients with OVCFs undergoing PVP surgery, especially in those with poor preoperative physical condition and presence of anemia.

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Availability of data and materials

The datasets generated during the current study are available from the corresponding author on reasonable request.

Abbreviations

OVCFs:

Osteoporotic vertebral compression fractures

CHD:

Coronary heart disease

PVP:

Percutaneous vertebroplasty

PMMA:

Polymethyl methacrylate

LOS:

Length of stay

HBL:

Hidden blood loss

UBE:

Unilateral biportal endoscopy

PELD:

Percutaneous endoscopic lumbar discectomy

HIS:

Hospital information system

BMI:

Body mass index

Hct:

Haematocrit

ALB:

Albumin

HB:

Hemoglobin

QCT:

Quantitative computed tomography

BMD:

Bone mineral density

ASA:

American Society of Anesthesiologists

TBL:

Total blood loss

PBV:

Patients’ blood volume

LOS:

Length of stay

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Acknowledgements

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Author notes

  1. Yun Yang and Yin-xiao Peng contribute equally to this study.

Authors and Affiliations

  1. Department of Orthopaedics, The Third People’s Hospital of Chengdu, Sichuan, People’s Republic of China

    Yun Yang & Yin-xiao Peng

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  1. Yun Yang
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Contributions

Conception and design: YY, YP. Collection and assembly of data: YY. Analysis and interpretation of the data: YY, YP. Drafting of the article: YY. Statistical expertise: YY, YP. Critical revision of the article for important intellectual content: YY. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yun Yang.

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The authors declare that they have no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at The Third People’s Hospital of Chengdu and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all patients.

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Yang, Y., Peng, Yx. Hidden blood loss and its risk factors in percutaneous vertebroplasty surgery for osteoporotic vertebral compression fractures. Arch Orthop Trauma Surg 143, 5575–5581 (2023). https://doi.org/10.1007/s00402-023-04873-3

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