Chung Wong Yu, Kit Lau Tsun, Wang Chau Wai, On Kwok Kin, Wai Law Sheung
Department of Orthopedics and Traumatology, Prince of Wales Hospital, Hong Kong, China.
Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
Spine Surg Relat Res. 2022 Oct 28;7(2):142-148. doi: 10.22603/ssrr.2022-0163. eCollection 2023 Mar 27.
Aspirin is commonly used for the primary and secondary prevention of cardiovascular disease and stroke. Controversy exists concerning whether and when is the optimal time to stop aspirin before spinal surgery. Previous studies on this topic mainly focused on patients who received thoracolumbar spine surgeries. There are only a few literatures concerning the safety of aspirin use in cervical spine surgery patients.
This pilot study recruited patients who received cervical laminoplasty from January 2010 to December 2021. The operation time, intraoperative blood loss, and postoperative complications of the patients who had taken aspirin during the perioperative period were compared with age, sex, and comorbidity-matched control patients. Propensity score matching was utilized in the selection of control to minimize bias.
Twenty-one patients who have received cervical laminoplasty while taking aspirin during the perioperative period were included. The control group included 21 age, sex, and comorbidity-matched patients who have not taken aspirin. The operation time and intraoperative and postoperative blood loss were higher in patients taking aspirin but were not statistically significant. There was no statistically significant difference in the wound infection rate. No case of epidural hematoma was found.
In patients undergoing cervical laminoplasty, a continuation of aspirin is safe and does not increase the difficulty of the surgery, wound complication, or hemorrhage.
阿司匹林常用于心血管疾病和中风的一级和二级预防。关于在脊柱手术前何时停用阿司匹林以及是否停用阿司匹林存在争议。此前关于该主题的研究主要集中在接受胸腰椎手术的患者身上。关于颈椎手术患者使用阿司匹林的安全性的文献较少。
这项前瞻性研究招募了2010年1月至2021年12月期间接受颈椎椎板成形术的患者。将围手术期服用阿司匹林的患者的手术时间、术中出血量和术后并发症与年龄、性别和合并症相匹配的对照患者进行比较。在选择对照时采用倾向评分匹配以尽量减少偏倚。
纳入了21例围手术期服用阿司匹林时接受颈椎椎板成形术的患者。对照组包括21例年龄、性别和合并症相匹配但未服用阿司匹林的患者。服用阿司匹林的患者手术时间以及术中及术后出血量较高,但无统计学意义。伤口感染率无统计学显著差异。未发现硬膜外血肿病例。
在接受颈椎椎板成形术的患者中,继续使用阿司匹林是安全的,不会增加手术难度、伤口并发症或出血情况。