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The evidence is critically analyzed and recommendation drawn.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The evidence for iron supplementation, autologous blood donation, screening for diatheses, the constitution of the surgical team, hypotensive anaesthesia, osteotomy, patient positioning, antifibrinolytics, transfusion thresholds, cell salvage, surgical technique, topical hemostasis, postoperative drainage, postoperative tranexamic acid and the management of thromboprophylaxis and anticoagulants is critically evaluated. The management of haemorrhage in surgery for adult spine deformity is complex and multifaceted, requiring the surgeon to consider tactics in conservation at every stage of the process. There is a paucity of evidence for many techniques, whilst hypotensive anaesthesia, tranexamic acid, surgical team members and surgical duration have the most significant effects on blood loss and transfusion requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The astute surgeon must consider strategies to prevent excessive haemorrhage in the pre- intra- and postoperative phases of care. Although some commonly used techniques have robust evidence, others may be at best poorly evidenced, and at worst ineffective. Surgeons should consider the members of the operative team, minimizing surgical time, preoperative correction of anemia, hypotensive anesthesia and the use of intravenous and topical tranexamic acid at a minimum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231188810","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:00:43Z","timestamp":1752073243000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Blood Management and Conservation During Adult Spine Deformity Surgery"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0808-5585","authenticated-orcid":false,"given":"Brett","family":"Rocos","sequence":"first","affiliation":[{"name":"Duke University"},{"name":"AO Knowledge Forum 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