Utilization of SURGIFLO® Hemostatic Matrix Reduces Intraoperative Blood Loss During Posterior Instrumented Thoracolumbar Spinal Surgery for Patients With Adult Spinal Deformity.

Background Massive blood loss is a major complication of posterior instrumented thoracolumbar surgery for adult spinal deformities. The use of flowable and absorbable hemostatic products, such as SURGIFLO® Hemostatic Matrix (SURGIFLO; ETHICON, Inc., Raritan, NJ, US), has become feasible for spinal surgery. Hence, a retrospective observational study was conducted to evaluate the efficacy of SURGIFLO during posterior instrumented thoracolumbar spinal surgery for an adult spinal deformity. Methods This analysis included 36 consecutive patients who underwent posterior instrumented thoracolumbar spinal surgery for an adult spinal deformity at our hospital from 2018 to 2022. Patients were divided into two groups: 19 who received SURGIFLO after March 2020 (Group S) and 17 who did not receive SURGIFLO before March 2020 (Group C). Operation time, intraoperative blood loss, postoperative blood loss (calculated from the suction drain until the next morning), and the number of perioperative blood transfusions were investigated. Results No significant differences were found between groups in terms of the number of fusion levels, osteotomy grades, and average operative times. However, Group S showed significantly less intraoperative blood loss per intervertebral level compared with Group C (p=0.023). Although the amount of concentrated red cells used did not differ significantly between groups, Group S required significantly less perioperative fresh frozen plasma than Group C (p=0.021). Conclusion In patients with an adult spinal deformity undergoing posterior instrumented spinal surgery from the thorax to the pelvis, utilization of SURGIFLO Hemostatic Matrix reduced intraoperative blood loss and the perioperative use of fresh frozen plasma.