ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Association of pre-closure intraoperative fibrinogen administration with early postoperative hemostasis in patients undergoing head-pelvic ring traction and three-column osteotomy for severe spinal deformity: a retrospective study.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSevere spinal deformity correction is associated with substantial perioperative blood loss. Evidence on pre-closure intraoperative fibrinogen administration in this setting remains limited. This study evaluated whether pre-closure intraoperative fibrinogen administration was associated with more favorable early postoperative hemostasis-related parameters.
methodsThis single-center retrospective study included 50 patients with severe spinal deformity who underwent head-pelvic ring traction followed by corrective surgery. Patients were classified into a fibrinogen group and a non-fibrinogen group according to whether they received pre-closure intraoperative fibrinogen administration. Postoperative coagulation parameters, hemoglobin (Hb) levels, drainage volume, and radiographic correction outcomes were compared between groups.
resultsTwenty-five patients were included in each group. Baseline characteristics, operative time, intraoperative blood loss, and radiographic correction outcomes were comparable between groups. Compared with the non-fibrinogen group, the fibrinogen group had lower postoperative prothrombin time and international normalized ratio, and higher prothrombin activity and fibrinogen levels (all P < 0.01). Hb levels on postoperative days 1 and 3 were higher in the fibrinogen group, whereas postoperative drainage volume and postoperative red blood cell transfusion volume were lower (P = 0.002, 0.036, 0.005, and < 0.001, respectively). No significant between-group difference was observed in Hb level on postoperative day 7.
conclusionsPre-closure intraoperative fibrinogen administration was associated with more favorable early postoperative hemostasis-related parameters in patients undergoing corrective surgery for severe spinal deformity. Given the retrospective design and potential residual confounding, these findings should be interpreted as hypothesis-generating and require validation in prospective studies.
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