Platelet aggregation inhibitor
The question of whether preoperative platelet aggregation inhibitors must be stopped before elective spinal surgery has never been answered in the literature.
In prospective series, it was not found no increase in the risk of postoperative spinal bleeding with the use of clopidogrel or acetylsalicylic acid. This finding suggests that spine surgery can be done without stopping anticoagulation. Lacking specific guidelines, each patient should be treated on an individual basis, and the potential benefits of anticoagulation should be compared with the potential risks (risk-benefit ratio) 1).
1)
Akhavan-Sigari R, Rohde V, Abili M. Continuation of medically necessary
platelet aggregation inhibitors - acetylsalicylic acid and clopidogrel - during
surgery for spinal degenerative disorders: Results in 100 patients. Surg Neurol
Int. 2014 Aug 28;5(Suppl 7):S376-9. doi: 10.4103/2152-7806.139675. eCollection
2014. PubMed PMID: 25289165; PubMed Central PMCID: PMC4173210.