Bulletin (Hospital for Joint Diseases (New York, N.Y.))
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Clinical Trial Controlled Clinical Trial
The results of intraoperative autotransfusion in orthopaedic surgery.
Perioperative hemorrhage associated with major orthopaedic surgery can become life threatening. Homologous bank blood transfusion can replace the volume of blood lost but it has serious disadvantages such as the transmission of viral agents, it has an insufficient platelet count, and transfusion reactions are possible. Hypotensive anesthesia, predeposited autologous blood transfusion and intraoperative autotransfusion are used to reduce these disadvantages. ⋯ The control group required an average of 3.2 +/- 2.1 units of bank blood. Preoperative and postoperative hematocrit values revealed a statistically significant difference between the autotransfusion group and the homologous transfusion group (p < 0.05). The results of this study suggest that intraoperative autotransfusion prevents the decrease in hematocrit values while reducing the need for bank blood transfusion and hence avoiding the risk of transmission of viral infections.
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Clinical Trial
Z-plate instrumentation in thoracolumbar spinal fractures.
Anterior decompression enables direct access and good canal clearance of the injury level in thoracolumbar spinal fractures, and decompressing the neural elements is shown to be an important factor for neurologic improvement and pain relief in many cases. In this study, results with anterior decompression and Z-plate instrumentation in thoracolumbar spinal fractures are reviewed. Nineteen patients with old spinal fracture (average: 3 years) and neural compression, and 15 patients with fresh thoracolumbar fractures with neurologic deficit and/or major anterior spinal canal obstruction had anterior decompression and Z-plate instrumentation with anterior fusion. ⋯ The unchanged positions of bone grafts and statistically insignificant loss of correction in the sagittal plane are accepted as evidence for bony fusion in all patients. Z-plate instrumentation provides stable fixation. Additionally, the technique can be performed easily and has the added benefit of being MRI-compatible.