Abstract | STUDY DESIGN: A report of two cases is presented. OBJECTIVE: SUMMARY OF BACKGROUND DATA: METHODS: Two spinal cases are reported, and the literature is reviewed. RESULTS: In the cases outlined, both patients underwent revision spinal surgery, with re-exposure to bovine thrombin. Both patients developed abnormal coagulation profiles, with an acquired factor V deficiency. No hemorrhagic complications occurred; however, second-stage surgery was delayed in one patient and not undertaken in the other. In both patients, the coagulopathy resolved spontaneously. CONCLUSIONS: Bovine thrombin-induced coagulopathy is well recognized in cardiac surgery but has not been reported in spinal surgical patients. Data available from cardiac surgical patients suggests that those who are sensitized to two or more bovine clotting factors are at greatest risk of hemorrhagic complications. The cases we present demonstrate that this phenomenon occurs in spinal surgical patients and serve to raise awareness of the potential danger of bovine thrombin in sensitized patients.
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Authors | Ashley R Poynton, Mark C Nelson, Sean E McCance, Randy L Levine, Patrick F O'Leary |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 28
Issue 12
Pg. E221-3
(Jun 15 2003)
ISSN: 1528-1159 [Electronic] United States |
PMID | 12811284
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Factor V
(antagonists & inhibitors, immunology)
- Factor V Deficiency
(chemically induced, immunology)
- Female
- Humans
- Kyphosis
(immunology, surgery)
- Male
- Middle Aged
- Orthopedic Fixation Devices
- Prothrombin Time
- Reoperation
- Spinal Fusion
- Spinal Stenosis
(immunology, surgery)
- Thrombin
(administration & dosage, adverse effects)
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