{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T13:49:03Z","timestamp":1778939343515,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Anterior cervical decompression and fusion (ACF) has become a widely accepted surgical treatment for degenerative cervical diseases, but occasionally, significant intraoperative blood loss (SIBL), which is defined as IBL of 500\u2009mL or more, will occur. We aimed to investigate the independent risk factors for SIBL during ACF for degenerative cervical diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 1150 patients who underwent ACF for degenerative cervical diseases at our hospital between 2013 and 2019. The patients were divided into two groups: the SIBL group (<jats:italic>n<\/jats:italic>\u2009=\u200938) and the non\u2010SIBL group (<jats:italic>n<\/jats:italic>\u2009=\u20091112). Demographic, surgical and radiographic data were recorded prospectively to investigate the independent risk factors for SIBL. For counting data, the chi\u2010square test or Fisher's exact probability test was used. Student's <jats:italic>t<\/jats:italic>\u2010test or the Mann\u2013Whitney rank sum test was used for comparisons between groups of measurement data. Univariate analysis and multivariate logistic regression analysis were further used to analyze the significance of potential risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of SIBL during ACF was 3.3% (38\/1150). A multivariate analysis revealed that female sex (odds ratio [OR], 6.285; 95% confidence interval [CI], 2.707\u201314.595; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), corpectomy (OR, 3.872; 95% CI, 1.616\u20139.275; <jats:italic>p<\/jats:italic>\u2009=\u20090.002), duration of operation \u2265150\u2009min (OR, 8.899; 95% CI, 4.042\u201319.590; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), C3 involvement (OR, 4.116; 95% CI, 1.808\u20139.369; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and ossification of posterior longitudinal ligament (OPLL) at the surgical level (OR, 6.007; 95% CI, 2.218\u201316.270; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were independent risk factors for SIBL. Patients with SIBL had more days of first\u2010degree\/intensive nursing (<jats:italic>p<\/jats:italic>\u2009=\u20090.003), longer length of stay (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and higher hospitalization costs (<jats:italic>p<\/jats:italic>\u2009=\u20090.023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Female sex, corpectomy, duration of operation, C3 involvement and OPLL at the surgical level were independent risk factors for SIBL during ACF. SIBL in ACF was associated with more days of first\u2010degree\/intensive nursing, longer length of stay and higher hospitalization costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13886","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T07:45:01Z","timestamp":1694763901000},"page":"2822-2829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk Factors for Significant Intraoperative Blood Loss during Anterior Cervical Decompression and Fusion for Degenerative Cervical Diseases"],"prefix":"10.1111","volume":"15","author":[{"given":"Hong","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics General Hospital of Northern Theater Command of Chinese PLA  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanhang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics General Hospital of Northern Theater Command of Chinese PLA  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics General Hospital of Northern Theater Command of Chinese PLA  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhonghua","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology General Hospital of Northern Theater Command of Chinese PLA  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics General Hospital of Northern Theater Command of Chinese PLA  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2367-3465","authenticated-orcid":false,"given":"Hongwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of 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