Nuttall et al identified risk factors for blood transfusion associated with spinal fusion surgery. The authors are from the Mayo Clinic in Rochester, Minnesota.


Factors affecting the amount of both allogeneic and autologous products:

(1) low preoperative hemoglobin

(2) increased number of posterior levels fused (which was associated with increased duration of the surgery)


Additional factors affecting the amount of allogeneic blood transfused:

(1) tumor surgery (which was associated with not using intraoperative blood salvage)

(2) history of pulmonary disease

(3) decreased number of autologous products available

(4) not using a Jackson table


Additional factors affecting the amount of autologous blood transfused:

(1) increased number of autologous products available



• Tables used were the anterior fusion, crest rolls Wilson frame, Jackson, 4-poster, tower and other. The Jackson table was used almost half of the patients.

• Patients undergoing tumor surgery usually did not have autologous products available.

• Intraoperative blood salvage tends not to be used if operating on malignant tumors.

• The Jackson table reduces intra-abdominal pressure, which may reduce bleeding from epidural veins during surgery.

• Administration of erythropoietin prior to surgery may help improve the preoperative hemoglobin, which may reduce the amount of transfused blood needed.


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