AMONG patients undergoing corrective surgery for severe spinal deformity, pre-closure intraoperative fibrinogen administration has been associated with more favourable early postoperative haemostasis-related parameters, according to a new retrospective study. The findings have been described by the authors as hypothesis-generating.
Severe spinal deformity correction is associated with substantial perioperative blood loss, yet evidence on pre-closure intraoperative fibrinogen administration in this setting was limited. It was unclear whether pre-closure intraoperative fibrinogen administration was associated with more favourable early postoperative haemostasis-related parameters, and this study has sought to address that evidence gap.
This single-centre 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, with 25 patients in each group. Postoperative coagulation parameters, haemoglobin (Hb) levels, drainage volume and radiographic correction outcomes were compared between the two groups.
Compared with the non-fibrinogen group, the fibrinogen group had lower postoperative prothrombin time and international normalised 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 (p=0.002 and p=0.036, respectively), whereas postoperative drainage volume (p=0.005) and postoperative red blood cell transfusion volume (p<0.001) were lower. No significant between-group difference was observed in Hb level on postoperative day 7.
These findings have suggested that pre-closure intraoperative fibrinogen administration is associated with more favourable early postoperative haemostasis-related parameters in patients undergoing corrective surgery for severe spinal deformity in this retrospective cohort. Given the retrospective design and potential residual confounding, the authors have advised that the findings should be interpreted as hypothesis-generating. Validation in prospective studies remains necessary to clarify whether these associations persist and translate into clinical benefit, although the current data are limited to early postoperative parameters in a single-centre sample.
Reference
Li H et al. 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. Eur Spine J. 2026;DOI:10.1007/s00586-026-10436-y.
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