The Influence of Central Venous Pressure on Blood Loss during Spinal Fusion in Prone Position

ABSTRACT

OBJECTIVE: The central venous pressure(CVP) could affect the vertebral venous pressure, which in turn may influence blood loss during lumbar spinal surgery. The authors perform prospective clinical study to investigate the influence of the CVP on the amount of intra-operative blood loss and operating time. METHODS: Total 134 patients having various degenerative lumbar spinal pathology were treated by laminectomy and spinal fusion using posterior lumbar interbody fusion with cages and pedicle screws. The CVP was measured after prone positioning in all the patients. The correlation between the CVP and intra-operative blood loss and operating time were analyzed. RESULTS: The mean CVP after prone positioning was 10 cmH2O(5-18). The mean amount of intra-operative blood loss and operating time were 1884 cc and 213 minutes, respectively. The amount of blood loss and operating time significantly increased with the extent of spinal fusion. The CVP was significantly correlated with intra-operative blood loss and operating time(p<0.05). CONCLUSION: With increased CVP on prone position, there is a tendency of increasing amount of blood loss and operating time. The measurement of CVP is useful in determining the position providing a bloodless field during spinal fusion.