Plasma Technology Reduces Blood Loss in Adolescent Idiopathic Scoliosis Surgery: A Prospective Randomized Clinical Trial.

STUDY DESIGN

Prospective randomized clinical trial.

OBJECTIVES

To assess the effectiveness of PEAK Plasmablade (PPB), compared with bipolar sealer and standard electrocautery, in the posterior spinal instrumentation and fusion (PSF) surgery performed for adolescent idiopathic scoliosis (AIS).

METHODS

Ninety-three patients undergoing PSF surgery for AIS were randomized in 2 groups: group-A patients (n = 45) underwent PSF surgery using PPB; group-B patients (n = 48) were treated with bipolar sealer and standard electrocautery. Demographic and surgical data was recorded. All the patients underwent serial blood tests on the day before surgery (T0) and at 24 (T1), 48 (T2), 72 (T3), and 96 (T4) hours postoperatively. Visual analogue scale for pain (VAS) score, the percentage of paracetamol assumption, and the blood transfusion rate were recorded in the time-lapse T1 to T4. Intergroup variability was assessed. Pearson correlation test was performed. A value <.05 was considered significant.

RESULTS

In group A, a significantly shorter total operative time ( = .0087), a significantly lower total intraoperative blood loss (TBL) ( = .001), and a higher postoperative hemoglobin (Hb) ( = .01) were recorded. A significant higher mean Hb concentration and mean albumin value was recorded in group A at 24 and 48 hours postoperatively. A significant correlation between TBL and hospital stay was recorded in both groups (group A, = .00 001; group B, = .00 006); moreover, in both groups, a significant correlation was observed between TBL and mean VAS at 72 hours postoperatively (group A, = .0009; group B, = .0001) and at 96 hours postoperatively (group A, = .000 044; group B, = .00 001).

CONCLUSIONS

PPB reduces the intraoperative blood loss in PSF performed for AIS, thus allowing a patient's faster recovery.