Intraoperative blood loss is a predictor for the development
One of the most prevalent consequences after spinal surgery is postoperative spinal implant (PSII) infection with a reported rates of 0.7–20 %. Although arthroplasty has found both the formation of haematoma and the perioperative blood loss as elements of risk for periprosthetic joint infections and preoperative anaemia as increasing complication rates.

A matched-pair analysis of perioperative haemoglobin (Hb) and haematocrit (Hct) levels in aseptic and septic spine revision surgeries was performed. 317 patients were included, 94 of which were classified as septic according to previously defined criteria. Patients were matched according to age, body mass index, diabetes, American Society of Anesthesiologists score and smoking habits. Descriptive summaries for septic and aseptic groups were analysed using Pearson chi-squared for categorical or Student t test for continuous variables.

--50 patients were matched and did not differ significantly in their reason for revision, mean length of hospital stay, blood transfusion, operating time, or number of levels operated on.

--While there was no significant difference in preoperative Hb or Hct levels, the mean difference between pre- and postoperative Hb was higher in the septic group (3.45 ± 1.25 vs. 2.82 ± 1.48 g/dL).

Conclusively, the intraoperative Hb trend is a predictor of PSII development, regardless of blood transfusion amounts, operating times, number of vertebral levels and hospital stay.