Impact of Antiplatelet Medication Continuation on Surgical Outcomes after Minimally Invasive Posterior Lumbar Decompression Surgery: Retrospective Cohort Study.

Study Design: Retrospective cohort study.

Objectives: Spinal surgeons face a dilemma regarding the continuation or discontinuation of antiplatelet agents during the perioperative period. Guidelines recommend considering the balance between thrombotic and bleeding risks. However, no consensus exists for the use of these agents for patients who undergo minimally invasive lumbar decompression. This study aimed to assess the effect of continued antiplatelet medication on minimally invasive posterior lumbar decompression surgery outcomes, focusing on perioperative outcomes and 1-year postoperative clinical results.

Methods: This study included 106 patients who underwent minimally invasive posterior lumbar decompression between 2017 and 2022 and were taking antiplatelet medications before spinal surgery. Patient characteristics, antiplatelet medication type, and perioperative data were analyzed. Patients were divided into "continuation" and "discontinuation" groups based on preoperative antiplatelet medication status. Univariate and multivariate linear regression analyses were performed.

Results: No significant differences were observed between groups in terms of surgical time, intraoperative blood loss, postoperative drain volume, complication rates, and Japanese Orthopedic Association scores and EuroQoL-5 dimensions 5-level at 1 year postoperatively. Similar results were noted in groups focusing exclusively on patients treated with aspirin. Multivariate linear regression revealed that surgical time per level was significantly associated with total blood loss, whereas antiplatelet medications did not show a significant relationship (operative time per level, < 0.01; antiplatelet drugs, = 0.459).

Conclusions: This study suggests that minimally invasive posterior lumbar spine decompression can be performed safely and effectively under continuous antiplatelet medication. Further studies with more evidence are required to validate our findings.