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The safety of perioperative antiplatelet continuation without selection biases in microsurgical decompression surgery for single level lumbar spinal stenosis and lumbar disc herniotomy – Lumbar Spinal Stenosis

The study aimed to determine the safety of continuing antiplatelet therapy during single-level microsurgical decompression (MSD) for lumbar spinal stenosis (LSS) and lumbar disc hernia (LDH). Data from patients who underwent surgery between April 2018 and December 2022 were collected and analyzed. After propensity score matching, it was found that there were no significant differences in reoperation rates, epidural hematoma volume, blood cell counts, and thromboembolic complications between the group that continued antiplatelet therapy and the control group. The conclusion of the study was that perioperative antiplatelet continuation is safe for single-level lumbar MSD without any biases

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced day surgery hospital in the world

Published article

CONCLUSION: Perioperative AP continuation is safe for single-level lumbar MSD, even without biases.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Acta Neurochir (Wien). 2024 Jun 12;166(1):262. doi: 10.1007/s00701-024-06156-1. ABSTRACT PURPOSE: Each institution or physician has to decide on an individual basis whether to continue or discontinue antiplatelet (AP) therapy before spinal surgery. The purpose of this study was to determine if perioperative AP continuation is safe during single-level microsurgical decompression (MSD) for treating lumbar spinal,

Acta Neurochir (Wien). 2024 Jun 12;166(1):262. doi: 10.1007/s00701-024-06156-1.

ABSTRACT

PURPOSE: Each institution or physician has to decide on an individual basis whether to continue or discontinue antiplatelet (AP) therapy before spinal surgery. The purpose of this study was to determine if perioperative AP continuation is safe during single-level microsurgical decompression (MSD) for treating lumbar spinal stenosis (LSS) and lumbar disc hernia (LDH) without selection bias.

METHODS: Patients who underwent single-level MSD for LSS and LDH between April 2018 to December 2022 at our institute were included in this retrospective study. We collected data regarding baseline characteristics, medical history/comorbidities, epidural hematoma (EDH) volume, reoperation for EDH, differences between preoperative and one-day postoperative blood cell counts (ΔRBC), hemoglobin (ΔHGB), and hematocrits (ΔHCT), and perioperative thromboembolic complications. Patients were divided into two groups: the AP continuation group received AP treatment before surgery and the control group did not receive antiplatelet medication before surgery. Propensity scores for receiving AP agents were calculated, with one-to-one matching of estimated propensity scores to adjust for patient baseline characteristics and past histories. Reoperation for EDH, EDH volume, ΔRBC, ΔHGB, ΔHCT, and perioperative thromboembolic complications were compared between the groups.

RESULTS: The 303 enrolled patients included 41 patients in the AP continuation group. After propensity score matching, the rate of reoperation for EDH, the EDH volume, ΔRBC, ΔHGB, ΔHCT, and perioperative thromboembolic complication rates were not significantly different between the groups.

CONCLUSION: Perioperative AP continuation is safe for single-level lumbar MSD, even without biases.

PMID:38864938 | DOI:10.1007/s00701-024-06156-1

The London Spine Unit : most advanced day surgery hospital in the world

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The safety of perioperative antiplatelet continuation without selection biases in microsurgical decompression surgery for single level lumbar spinal stenosis and lumbar disc herniotomy

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Acta Neurochir (Wien). 2024 Jun 12;166(1):262. doi: 10.1007/s00701-024-06156-1. ABSTRACT PURPOSE: Each institution or physician has to decide on an individual basis whether to continue or discontinue antiplatelet (AP) therapy before spinal surgery. The purpose of this study was to determine if perioperative AP continuation is safe during single-level microsurgical decompression (MSD) for treating lumbar spinal
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