Elevating Patient Care: Addressing Spine Surgery Challenges

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Patient profiles are changing, increasing the risk of bleeding and healing complications in spine surgery.1

Between 2015 and 2050,

the proportion of the world's population over 60 years will nearly double from 12% to 22%2

30%

of the US population use low-dose aspirin for cardiovascular disease prevention3

~2/3

of US surgical patients are treated with anticoagulants and/or antiplatelets4

1 in 3 women and 1 in 5 men

over age 50 will experience osteoporosis fractures in their remaining lifetimes5

More than 2 in 5 adults

have obesity6

Each spine procedure provides unique challenges that can cause complications for the healing process.7-9

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There is a high incidence of bleeding and healing-related complications in spine surgery.

30%

of approximately all spine surgery patients require blood transfusions.10

141%

Approximately 141% higher cost associated with procedures involving CSF leaks in neurosurgery.11

13.9%

Up to 13.9% operative nonunion rate with increased risk of nonunion for constructs that include L5-S1 and ≥3-level fusions.12

83%

On average, there is an up to 83% increase in total cost of care for spine surgery patients with bleeding related complications, according to a U.S. case report analysis.13

33.8%

Revision rates of up to 33.8% in spine surgeries present a major challenge for surgeons and the healthcare system.14

The impact of a CSF leak in cranial and spinal surgery

A major complications in cranial and spinal surgery is the post-operative occurrence of a CSF leak, which exposes patients to higher risk of infection, prolonged hospital stay, and in many cases need of reoperation, thus increasing healthcare costs.15

csfleaks

Achieving Fusion

As a patient’s osteogenic capacity decreases due to aging and comorbidities, reliance on the graft material increases.16-17 Fusion rates can potentially be improved by choosing the most effective bone graft that actively promotes or enhances the regeneration process.17

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Preventing and Fixing CSF Leaks

Significant bleeding can result in loss of visualization leading to nerve injury or dural tears.18 Visualizing the anatomy during spine surgery is critical to an efficient and successful surgery.18

Watertight dural closure may reduce or avoid the complication of CSF leak19, decreasing the likelihood of surgical site infections and revisions surgeries, reducing hospital stays.15

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Spine Surgeons and Neurosurgeons Agree on the Importance of an intraoperative Bleeding Scale 

Use of the VIBe Scale tool may reduce complications that may results from the inappropriate choice of hemostatic agents. 1,22

Additionally, the preoperative use of the VIBe Scale tool may support a proactive hemostasis strategy and control of bleeding required in increasingly complex procedures. 23

 

100%

25 of 25 surgeons agreed VIBe Scale tool is representative of bleeding size and severity23

96%

24 of 25 surgeons agreed VIBe Scale tool differentiates hemostats23

88%

22 of 25 surgeons agreed VIBe Scale tool is representative of bleeding size and severity23

96%

24 of 25 surgeons agreed VIBe Scale tool is useful in communicating bleeding severity23*

Put your patients at the core

Stay up to date with the latest spine/neuro events and resources

  1. Iannitti DA, Kim  C, Ito, D et al. Impact of an active hemostatic product treatment approach on bleeding-related complications and hospital costs among inpatient surgeries in the United States. J Med Econ. 2021;24(1):514-523.
  2. World Health Organization: WHO. (2022). Ageing and health. Available at: www.who.int.https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed May 2023.
  3. Stuntz M, Bernstein B. Recent trends in the prevalence of low-dose aspirin use for primary and secondary prevention of cardiovascular disease in the United States, 2012-2015. Prev Med Rep. 2017;5:183-186.
  4. Preliminary Results, Summary of Premier Data, 2018Q1 to 2019Q2. Baxter Data on File. REF-30481.
  5. International Osteoporosis Foundation. Epidemiology. Available at: https://www.osteoporosis.foundation/healthprofessionals/fragility-fractures/epidemiology. Accessed May 2023.
  6. National Institute of Diabetes and Digestive and Kidney Diseases. Obesity Statistics. Available at: https://www.niddk.nih.gov/health-information/healthstatistics/overweight-obesity. Accessed May 2023.
  7. Lee C, Dorcil J, Radomisli TE. Nonunion of the spine: a review. Clin Orthop Relat Res. 2004;419:71-75.
  8. Ramirez MG, Niu X, Epstein J, et al. Cost-consequence analysis of a hemostatic matrix alone or in combination for spine surgery patients. J Med Econ. 2018;21:1041-1046.
  9. Jesse CM, Schermann H, Goldberg J, et al. Risk factors for postoperative cerebrospinal fluid leakage after intradural spine surgery. World Neurosurg. 2022;164:e1190-e1199.
  10. Aoude A, Nooh A, Fortin M, et al. Incidence, predictors, and postoperative complications of blood transfusion in thoracic and lumbar fusion surgery: An analysis of 13,695 patients from the American College of Surgeons National Surgical Quality Improvement Program Database. Glob Spine J. 2016;6:756‑764.
  11. Grotenhuis JA. Costs of postoperative cerebrospinal fluid leakage: 1-year, retrospective analysis of 412 consecutive non-trauma cases. Surg Neurol. 2005;64:490-493.
  12. Guppy KH, Royse KE, Norheim EP, et al. Operative nonunion rates in posterolateral lumbar fusions: analysis of a cohort of 2591 patients from a national spine registry. World Neurosurg. 2021;145:e131-e140.
  13. Stokes Me, Ye X, Shah M, et al. Impact of bleeding-related complications and/or blood product transfusion on hospital costs in inpatient surgical patients. BMC Health Services Research. 2011;11:135.
  14. Laubach M, Kobbe P, Hutmacher DW. Biodegradable interbody cages for lumbar spine fusion: Current concepts and future directions. Biomaterials. 2022;288:121699.
  15. Montano N, Giordano M, Caccavella VM, et al. Hemopatch® with fibrin glue as a dural sealant in cranial and spinal surgery. A technical note with a review of the literature. J Clin Neurosci. 2020;79:144-147.
  16. Kim BH, Jung HG, Park KH, et al. The effectiveness of bone mineral density as supplementary tool for evaluation of the osteogenic potential in patients with spinal fusion. Asian Spine J. 2009;3:1-89.
  17. Dvorakova J, Wiesnerova L, Chocholata P, et al. Human cells with osteogenic potential in bone tissue research. Biomed Eng Online. 2023;22:33.
  18. Renkens KL, Payner TD, Leipzig TJ, et al. A multicenter, prospective, randomized trial evaluating a new hemostatic agent for spinal surgery. Spine. 2001;26:1645-1650.
  19. Wright NM, Park J, Tew JM, et al. Spinal sealant system provides better intraoperative watertight closure than standard of care during spinal surgery. Spine. 2015;40:505-513.
  20. Mikhail C, Pennington Z, Arnold PM, et al. Minimizing blood loss in spine surgery. Global Spine J. 2020;10:71S-83S.
  21. Delawan M, Sharma M, Ismali M, et al. Methods of hemostasis in cranial neurosurgery: ana anatomy-based stepwise review. World Neurosurg. 2023;178:241-259.
  22. Lewis KM. Li Q, Jones DS, et al. Development and validation of an intraoperative bleeding severity scale for use in clinical studies of hemostatic agents. Surgery. 2017;161(3):771-781.
  23. Sciubba D, Khann N, Pennington Z, et al. VIBe Scale: Validation of the intraoperative bleeding severity scale by spine surgeons. Int J Spine Surg. 2022;16:740-747.
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