• Dennis S Meredith, Christopher K Kepler, Russel C Huang, Brandon Hirsch, Joseph Nguyen, James C Farmer, Federico P Girardi, Patrick F O'Leary, and Frank P Cammisa.
• Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th ST, New York, NY 10021, USA. meredithd@hss.edu
• Eur Spine J. 2012 Dec 1;21(12):2659-63.

PurposeTo investigate the effect of omega-3 fatty-acid supplements (n-3FA) on bleeding during posterior spinal arthrodesis.MethodsWe 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.ResultsTwenty-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.ConclusionsThe n-3FA use did not contribute to higher perioperative blood loss during spinal arthrodesis.

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