Application Value of Intraoperative Salvaged Autotransfusion during Posterior Lumbar Fusion: A Retrospective Study

Abstract Objective: To understand the application value of intraoperative salvaged autotransfusion（ISA）during posterior lumbar decompression and fusion(PLDF) and transforaminal lumbar interbody fusion（TLIF）at ≥1 surgical segments.Methods: Patients who underwent either procedure between January 2015 and January 2018 were enrolled. The patients were divided into two groups according to whether undergone ISA. Patient information, transfusion, clinical, and surgical data were analyzed for determine the clinical significance of ISA.Results: 412 patients were enrolled into two groups:181 in the ISA group and 231 in the non-ISA group. The overall requirement and volumes for allogeneic blood were significantly lower in the ISA group. TLIF at ≥2 segments resulted in significantly lower usage rate of allogeneic blood in the ISA group. During PLDF , the usage rate and volumes of allogeneic blood in the ISA group were significantly lower in both 1 and ≥2 surgical segment numbers Conclusion: The application value of ISA depends on the operation style and number of segments. During TLIF, ISA may not offer any additional clinical benefit in one segment, and the benefit in ≥ 2 segment should be invested further. During PLDF, in ISA group，the demand for allogeneic blood was reduced and patients own blood resources were effectively utilized regardless of surgical segment numbers.