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Antithrombotic Effects of Aspirin on 1- or 2-Level Lumbar Spinal Fusion Surgery: A Comparison Between 2 Groups Discontinuing Aspirin Use Before and After 7 Days Prior to Surgery

Park, Jin Hoon MD, PhD*; Ahn, Yongchel MD; Choi, Byeong Sam MD**; Choi, Kyu-Taek MD, PhD§; Lee, Kyuhwak MD[BULLET OPERATOR]; Kim, Se Hun MD; Roh, Sung Woo MD, PhD

doi: 10.1097/BRS.0b013e31829a84d2
Clinical Case Series

Study Design. Retrospective clinical analysis.

Objective. To study proper discontinuation date of aspirin in spinal fusion surgery.

Summary of Background Data. It is thought that excess bleeding can be normalized if aspirin intake is discontinued approximately 7 days before surgery; however, the average life span of a platelet is generally regarded to be 7 to 10 days.

Methods. From January 2004 to December 2009, a single surgeon performed 182 cases of 1- or 2-level lumbar fusion surgical procedures. Patients who were aspirin users (n = 86) were divided into 2 groups according to the number of days prior to surgery that they discontinued their aspirin use: the aspirin 1 group discontinued their aspirin use 3 to 7 days before surgery and the aspirin 2 group discontinued their aspirin use 7 to 10 days before surgery. Ninety-six patients who did not use aspirin before surgery were selected for the control group. We retrospectively compared the several hematological parameters among the 2 aspirin groups and the control group.

Results. Both the total amount of drained blood and the duration of indwelling of the drainage catheter were significantly less in the control group than in the aspirin 1 group in patients who underwent either type of 1-level fusion surgery. However, those were not significantly different between aspirin 2 group and control group in patients who underwent either type of 1-level fusion surgery. Only drainage catheter was significantly less in the control group than in the aspirin 1 group in patients who underwent 2-level fusion surgery.

Conclusion. Only the aspirin 1 group, wherein patients discontinued aspirin use 3 to 7 days before surgery, showed a greater drained blood and drainage catheter than the control group. If aspirin was discontinued 7 days or longer before surgery, there was no difference in the study parameters, compared with the control group.

Level of Evidence: 3

The patients discontinued aspirin use 3 to 7 days before spinal fusion surgery and showed a greater amount of drained blood and duration of drainage catheter than control group. If aspirin was discontinued 7 days or longer before surgery, there was no difference in the study parameters compared with control group.

From the Departments of *Neurological Surgery

Hemato-oncology, and

Anesthesiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea;

§Departments of Anesthesiology

Neurological surgery, and

[BULLET OPERATOR]General Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea; and

**Department of Neurological Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address correspondence and reprint requests to Sung Woo Roh, MD, PhD, Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea; E-mail: swroh@amc.seoul.kr

Acknowledgment date: January 18, 2013. First revision date: April 1, 2013. Acceptance date: May 6, 2013.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2013 by Lippincott Williams & Wilkins