Daily Aspirin and Spinal Surgery

Daily Aspirin and Spinal Surgery

Many people take a low-dose aspirin each day. This inexpensive little pill has been shown in numerous studies to decrease the risk of nonfatal heart attack, some forms of cancer, and overall risk of death. On the other hand, low-dose aspirin does increase the risk of bleeding. For most, this increased risk of bleeding is outweighed by the many health benefits. But what about aspirin and surgery?

Follow your physician’s instructions

There is no single rule about daily aspirin use and surgery. Continued aspirin use may be safe for some people and for certain types of surgeries. For some, aspirin may need to be stopped because the risk of bleeding is too great.

People undergoing elective surgery, urgent surgery, and even some forms of orthopedic surgery seem to be able to safely take low-dose aspirin without significant increase in dangerous bleeding. Nevertheless, you should follow your doctor’s instructions regarding aspirin use before and after surgery. If you are not sure which drugs to continue and which to stop, make sure to ask your surgeon in advance of the procedure.

Aspirin may be safe in spinal surgery

While you should always follow your surgeon’s recommendations, new research is emerging that suggests daily aspirin use may be safe even during spinal surgery. Researchers followed a group of patients with cardiac stents who required spinal surgery. A cardiac stent is a metal tube that holds the coronary artery open, allowing blood to flow to the heart. A person with a cardiac stent must take daily aspirin to help prevent blood clots from forming in the coronary artery.

In the study, one group continued to take aspirin each day while the other group stopped taking aspirin before the procedure. Both groups had roughly the same blood loss during the procedure, the same operative time, and the same length of stay in the hospital. The number of blood transfusions and 30-day readmission to the hospital was the same between the two groups as were overall complication rates.

Daily aspirin use was relatively safe in patients undergoing spinal surgery and did not increase risks compared to people who stop taking daily aspirin for the procedure.4 If you take an aspirin a day, make sure to ask your surgeon what you should do about your aspirin use prior to spinal surgery.

References

  1. Harty J, McKenna P, Moloney D, D’Souza L, Masterson E. Anti-platelet agents and surgical delay in elderly patients with hip fractures. Journal of Orthopaedic Surgery. 2007;15(3).
  2. Mantz J, Samama C, Tubach F, et al. Impact of preoperative maintenance or interruption of aspirin on thrombotic and bleeding events after elective non-cardiac surgery: the multicentre, randomized, blinded, placebo-controlled, STRATAGEM trial. British journal of anaesthesia. 2011:aer274.
  3. Chechik O, Thein R, Fichman G, Haim A, Tov TB, Steinberg EL. The effect of clopidogrel and aspirin on blood loss in hip fracture surgery. Injury. 2011;42(11):1277-1282.
  4. Cuellar JM, Petrizzo A, Vaswani R, Goldstein JA, Bendo JA. Does Aspirin Administration Increase Perioperative Morbidity in Patients With Cardiac Stents Undergoing Spinal Surgery? Spine (Phila Pa 1976). 2015;40(9):629-635.

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