Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, China.
Department of Orthopedics, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Eur Spine J. 2023 Mar;32(3):1021-1028. doi: 10.1007/s00586-023-07554-2. Epub 2023 Jan 30.
The purpose of our study is to identify the effect of short-term and high-dose use of erythropoietin (EPO) in spinal isolated metastatic patients with Total en bloc spondylectomy (TES) surgery by assessing hematological parameters, transfusion volume, postoperative complications, recurrence-free survival (RFS), and overall survival (OS).
From January 2015 and January 2022, 93 isolated spinal metastasis patients were selected and separated into 2 groups based on the treatment method used (EPO + TXA (Tranexamic acid) group, n = 47; and TXA group, n = 46). Indexes for evaluation included hemoglobin (Hb), hematocrit (Hct), red blood cells (RBC), RFS, OS, postoperative complications, postoperative Frankel Grade, drainage volume, transfusion rate, and mean units transfused.
The average follow-up duration was 38.13 months. There was no significant difference (P > 0.05) in RFS, OS, postoperative complications, postoperative Frankel Grade, drainage volume, and transfusion rate between the two groups. However, patients in EPO + TXA group have significantly higher Hb, Hct, and RBC values than those in the TXA group on postoperative days 1, 2, 3, and 5. Moreover, the mean transfusion volume in EPO + TXA group was significantly lower than those in the TXA group (P = 0.011).
Perioperative short-term and high-dose administration of EPO could improve the anemia-related hematological parameters and reduce the requirement for blood transfusion without increasing the risk of deep vein thrombosis and tumor progression in solitary spinal metastatic patients with TES surgery.
本研究旨在通过评估血液学参数、输血量、术后并发症、无复发生存率（RFS）和总生存率（OS），来确定短期和高剂量使用促红细胞生成素（EPO）对行全脊椎整块切除术（TES）的孤立性脊柱转移患者的影响。
从 2015 年 1 月至 2022 年 1 月，选择了 93 例孤立性脊柱转移患者，并根据治疗方法将其分为两组（EPO+TXA（氨甲环酸）组，n=47；和 TXA 组，n=46）。评估指标包括血红蛋白（Hb）、红细胞压积（Hct）、红细胞（RBC）、RFS、OS、术后并发症、术后 Frankel 分级、引流量、输血率和平均输血量。
平均随访时间为 38.13 个月。两组的 RFS、OS、术后并发症、术后 Frankel 分级、引流量和输血率均无统计学差异（P>0.05）。然而，EPO+TXA 组患者在术后第 1、2、3 和 5 天的 Hb、Hct 和 RBC 值明显高于 TXA 组。此外，EPO+TXA 组的平均输血量明显低于 TXA 组（P=0.011）。
在接受 TES 手术的孤立性脊柱转移患者中，围手术期短期和高剂量使用 EPO 可改善与贫血相关的血液学参数，并减少输血需求，而不会增加深静脉血栓形成和肿瘤进展的风险。
