Blood loss in major spine surgery: are there effective measures to decrease massive hemorrhage in major spine fusion surgery?

i) Study design: Systematic review (17 articles)
ii) Current literature suggests that there is little support for routine use of Cell Saver during elective spinal surgery.
iii) There is a high level of evidence that antifibrinolytic agents reduce blood loss and the need of transfusion in adult spine surgery; however, the safety profile of these agents is unclear.

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