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Original Article
DOI: https://doi.org/10.13107/jcorth.2026.v11.i01.846
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Postoperative Hemoglobin Change and Blood Transfusion Requirement Following Open Lumbar Surgery: A 20-Patient Case Series

Original Article | Volume 11 | Issue 1 | JCORTH Jan-Jun 2026 | Page 78-81 | Sumedha Shinde [1], Arvind J. Vatkar [2], Saloni Mhatre [3], Sahil Dabholkar [3], Gaurav Gupta [4], Gursimran Singh Sandhu [3], Elvin Anto Keettikal [3] . DOI: https://doi.org/10.13107/jcorth.2026.v11.i01.846
Authors: Sumedha Shinde [1], Arvind J. Vatkar [2], Saloni Mhatre [3], Sahil Dabholkar [3], Gaurav Gupta [4], Gursimran Singh Sandhu [3], Elvin Anto Keettikal [3]
[1] Department of Immuno Haematology and Blood Transfusion, Dr. D.Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, MGM Medical College, Navi Mumbai, Maharashtra, India.
[3] Department of Orthopaedics, Dr D Y Patil School of Medicine, Navi Mumbai, Maharashtra, India.
[4] Central Institute of Orthopaedics, Safdarjung Hospital, New Delhi, India.
Address of Correspondence:
Dr. Sumedha Shinde, Department of Immuno Haematology and Blood Transfusion, Dr. D.Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India. E-mail: sumedhashinde@gmail.com
Article Received : 2025-12-29,
Article Accepted : 2026-04-19

Abstract

Background: Postoperative anemia remains an important concern after open lumbar surgery because hemoglobin decline may delay recovery and increase the need for allogeneic blood transfusion.

Objective: To analyze perioperative hemoglobin change, estimated blood loss, and postoperative blood transfusion requirement in a 20-patient case series of open lumbar surgery.

Methods: A retrospective observational analysis was performed using the uploaded dataset of 20 patients undergoing open lumbar surgery. Variables included age, sex, number of lumbar levels operated, preoperative hemoglobin, postoperative hemoglobin, estimated blood loss, and postoperative transfusion requirement. Hemoglobin drop was calculated as preoperative minus postoperative hemoglobin, paired t-test was used to compare preoperative and postoperative hemoglobin, one-way ANOVA was used to compare hemoglobin drop across surgical levels, and linear regression was applied to assess the effect of additional operated levels on hemoglobin reduction.

Results: The cohort comprised 20 patients with mean age 59.5 ± 9.7 years; 15 were male and 5 were female. Mean preoperative hemoglobin was 13.06 ± 0.99 g/dL, mean postoperative hemoglobin was 11.92 ± 1.61 g/dL, and mean hemoglobin drop was 1.13 ± 0.90 g/dL. The reduction in hemoglobin was statistically significant (t = 5.65, p = 0.0000). Mean estimated blood loss was 252.5 ± 129.2 mL. Hemoglobin drop increased significantly with the number of operated levels, with a regression equation of hemoglobin drop = -0.23 + 0.85 × (number of levels), corresponding to an increment of 0.85 g/dL per additional level (95% CI 0.44 to 1.26; p = 0.0004; R² = 0.508). Postoperative allogeneic transfusion was required in 3 patients (15.0%), and each of these patients received 1 pint of blood.

Conclusion: Open lumbar surgery was associated with significant postoperative hemoglobin decline, and multilevel surgery showed greater hemoglobin reduction and a higher need for postoperative blood transfusion.

Keywords: Lumbar surgery, TLIF, Hemoglobin, Blood loss, Postoperative anemia, Transfusion.

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© 2026 Journal of Clinical Orthopaedics
How to Cite This Article: Shinde S, Vatkar AJ, Mhatre S, Dabholkar S, Gupta G, Keettikal EA. Postoperative Hemoglobin Change and Blood Transfusion Requirement Following Open Lumbar Surgery: A 20-Patient Case Series. Journal of Clinical Orthopaedics 2026 May, 11(05): 78-81.