Bipolar sealer device reduces blood loss and transfusion requirements in posterior spinal fusion for degenerative lumbar scoliosis

Study Design: A prospective, randomized, controlled clinical study. Objective: To determine the efficacy of bipolar sealer device in reducing perioperative blood loss and transfusions in degenerative lumbar scoliosis patients undergoing primary posterior spinal fusion. Background: It has recently been used successfully in pediatric spine surgery, particularly in idiopathic and neuromuscular deformities. However, there is a dearth of literature on prospective study of the efficacy of bipolar sealer device in reducing perioperative blood loss and transfusions in patients undergoing degenerative lumbar scoliosis surgery. Methods: A total of 100 consecutive degenerative lumbar scoliosis patients who had undergone primary decompression and posterior spinal fusion with segmental spinal instrumentation between June 2010 and June 2012 were prospectively randomized into 1 of 2 groups according to whether bipolar sealer device for intraoperative/postoperative blood management was used or not. Demographic distribution, perioperative blood loss, blood transfusion rate, the length of stay, and postoperative complications were analyzed. Results: The operation time was significantly shorter in the study group than in the control group, 223.4 versus 248.9 minutes (P=0.026). There was significantly lower intraoperative estimated blood loss in the bipolar sealer group, 407 versus 696 mL (P=0.000). Of the patients with the use of bipolar sealer device, the mean red blood cell transfusion requirement during hospitalization was significantly less than the control group, 0.4 versus 1.1 U/patient (P=0.003). Furthermore, significant difference existed in allogenic blood transfusion rate between the 2 cohorts. Within the study group (with the use of bipolar sealer device), the entire perioperative allogenic blood transfusion rate was 18.0% compared with 40.0% of the control group (P=0.015). There were no complications related directly to the use of the bipolar sealer. Conclusions: Utilization of a bipolar sealer during correction of lumbar degenerative scoliosis may offer comparable hemostatic effects, without prohibitive cost or adverse drug-related risks.