European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
Association of pre-closure intraoperative fibrinogen administration with early postoperative hemostasis in patients undergoing head-pelvic ring traction and three-column osteotomy for severe spinal deformity: a retrospective study.
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Li Hongzhen, Liang Yan, Liang Yijian, Zhao Deng
Аннотация
BACKGROUND: Severe spinal deformity correction is associated with substantial perioperative blood loss. Evidence on pre-closure intraoperative fibrinogen administration in this setting remains limited. This study evaluated whether pre-closure intraoperative fibrinogen administration was associated with more favorable early postoperative hemostasis-related parameters.
METHODS: This single-center retrospective study included 50 patients with severe spinal deformity who underwent head-pelvic ring traction followed by corrective surgery. Patients were classified into a fibrinogen group and a non-fibrinogen group according to whether they received pre-closure intraoperative fibrinogen administration. Postoperative coagulation parameters, hemoglobin (Hb) levels, drainage volume, and radiographic correction outcomes were compared between groups.
RESULTS: Twenty-five patients were included in each group. Baseline characteristics, operative time, intraoperative blood loss, and radiographic correction outcomes were comparable between groups. Compared with the non-fibrinogen group, the fibrinogen group had lower postoperative prothrombin time and international normalized ratio, and higher prothrombin activity and fibrinogen levels (all P < 0.01). Hb levels on postoperative days 1 and 3 were higher in the fibrinogen group, whereas postoperative drainage volume and postoperative red blood cell transfusion volume were lower (P = 0.002, 0.036, 0.005, and < 0.001, respectively). No significant between-group difference was observed in Hb level on postoperative day 7.
CONCLUSIONS: Pre-closure intraoperative fibrinogen administration was associated with more favorable early postoperative hemostasis-related parameters in patients undergoing corrective surgery for severe spinal deformity. Given the retrospective design and potential residual confounding, these findings should be interpreted as hypothesis-generating and require validation in prospective studies.
METHODS: This single-center retrospective study included 50 patients with severe spinal deformity who underwent head-pelvic ring traction followed by corrective surgery. Patients were classified into a fibrinogen group and a non-fibrinogen group according to whether they received pre-closure intraoperative fibrinogen administration. Postoperative coagulation parameters, hemoglobin (Hb) levels, drainage volume, and radiographic correction outcomes were compared between groups.
RESULTS: Twenty-five patients were included in each group. Baseline characteristics, operative time, intraoperative blood loss, and radiographic correction outcomes were comparable between groups. Compared with the non-fibrinogen group, the fibrinogen group had lower postoperative prothrombin time and international normalized ratio, and higher prothrombin activity and fibrinogen levels (all P < 0.01). Hb levels on postoperative days 1 and 3 were higher in the fibrinogen group, whereas postoperative drainage volume and postoperative red blood cell transfusion volume were lower (P = 0.002, 0.036, 0.005, and < 0.001, respectively). No significant between-group difference was observed in Hb level on postoperative day 7.
CONCLUSIONS: Pre-closure intraoperative fibrinogen administration was associated with more favorable early postoperative hemostasis-related parameters in patients undergoing corrective surgery for severe spinal deformity. Given the retrospective design and potential residual confounding, these findings should be interpreted as hypothesis-generating and require validation in prospective studies.