Safety of Continuous Low-Dose Aspirin Therapy for Cervical Laminoplasty

INTRODUCTION: More spinal surgeries are being performed in patients taking low-dose aspirin for primary and secondary prevention of cardiovascular and cerebrovascular ischemic disease. However, there are no recommended guidelines for perioperative aspirin use in patients undergoing spinal surgery. This study evaluated the perioperative effect of continued low-dose aspirin on cervical laminoplasty. METHODS: This was a single-institute retrospective study of patients who underwent laminoplasty at the C2/3 to C7/T1 levels for cervical compression lesions. The comparison of 73 patients who continued to take aspirin at 100 mg/day during the perioperative period and 322 patients who took no antiplatelet or anticoagulant drugs examined their patient characteristics, perioperative parameters, and perioperative complications. RESULTS: A significantly higher proportion of patients with aspirin were men, and the mean age was significantly higher in patients with than without aspirin (P=0.011 and P<0.001, respectively). The preoperative hemoglobin level was significantly lower in patients with than without aspirin (P=0.033). The number of disk decompression levels, surgical time, intraoperative blood loss, and postoperative drainage volume were not significantly different between patients with and without aspirin. Reoperation for epidural hematoma formation was also not significantly different between patients with and without aspirin. Perioperative blood transfusions were performed in 1 of 73 patients with aspirin and 0 of 322 patients without aspirin, with no significant difference (P=0.185). No cardiovascular or cerebrovascular ischemic events occurred in either group. CONCLUSIONS: Continuing low-dose aspirin therapy during a perioperative period for cervical laminoplasty did not increase perioperative bleeding or the risk of bleeding-related complications. Therefore, continuing low-dose aspirin may be acceptable for patients undergoing cervical laminoplasty to prevent increased risk of cardiovascular and cerebrovascular accidents due to aspirin withdrawal.