ABSTRACT
The ability to maintain hemodynamic stability, stop intraoperative bleeding, and manage cerebrospinal fluid leakage has long been important to the successful practice of spine surgery. Over the last several years, many advancements have been made in these areas that have improved the morbidity of spinal procedures, particularly complex ones involving extensive dissection, instrumentation, and lengthy operative times. However, each new advance brings its own set of unique iatrogenic risks, of which the spine surgeon must be aware. This chapter will discuss the risks, benefits, and efficacy of intraoperative blood transfusions, topical hemostatic agents, and dural substitutes, allowing the spine surgeon to make informed decisions regarding the use of these adjuncts.
