Safety of Continuous Low-Dose Aspirin Therapy for Lumbar Decompression Alone

Introduction: Whether the benefits of continued perioperative aspirin therapy in spinal surgery outweigh the risk of perioperative complications remains unclear. This study evaluates the perioperative effects of continuous low-dose aspirin treatment in patients who underwent lumbar decompression alone. Methods: This single-institute retrospective study included patients who underwent lumbar decompression for L1/2-L5/S1 lesions. The patient characteristics, perioperative parameters, and complications were compared between 103 patients who continued to take 100 mg/day aspirin during the perioperative period (aspirin group) and 653 patients who did not take antiplatelet or anticoagulant drugs (nonaspirin group). Results: A significantly higher proportion of the patients in the aspirin group were males. The patients in the aspirin group had significantly lower preoperative hemoglobin levels than those in the non-aspirin group (P=0.001 and P=0.044, respectively). No significant differences were detected between the groups in terms of the number of disc decompression levels, duration of surgery, intraoperative blood loss, postoperative drainage volume, number of reoperations required for epidural hematoma formation, or perioperative blood transfusions. No cardiovascular or cerebrovascular ischemic events occurred in either group. Conclusions: Continuous low-dose aspirin therapy alone during the perioperative period for lumbar decompression did not increase perioperative bleeding or the risk of bleeding-related complications. In conclusion, continuous low-dose aspirin treatment may be acceptable for use in preventing the increased risk of cardiovascular disease caused by aspirin withdrawal in patients undergoing lumbar decompression.