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World J Orthop. Jun 18, 2026; 17(6): 119695
Published online Jun 18, 2026. doi: 10.5312/wjo.v17.i6.119695
Published online Jun 18, 2026. doi: 10.5312/wjo.v17.i6.119695
Hidden blood loss in dual media spinal endoscopy surgery: Analysis of perioperative risk factors
Peng-Huan Ye, Department of Orthopedics, Hangzhou Medical College, Hangzhou 311300, Zhejiang Province, China
Hao Zhang, Xun Wu, Department of Orthopedics, Jinhua People’s Hospital, Jinhua 321000, Zhejiang Province, China
Yu Zeng, Department of Orthopedics, Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China
Sheng-Hui Su, Department of Orthopedics, Ningbo No. 2 Hospital, Wenzhou Medical University, Ningbo 315000, Zhejiang Province, China
Co-corresponding authors: Yu Zeng and Sheng-Hui Su.
Author contributions: Ye PH, Zhang H and Wu X collected the data, analyzed the data and drafted the manuscript; Zeng Y and Su SH supervised the project and reviewed the manuscript; Ye PH, Zhang H and Su SH conceived the study, and participated in its design and coordination; Su SH was responsible for the overall project and supervised the study. All authors read and approved the final manuscript. In this study, Zeng Y and Su SH are designated as co-corresponding authors. This decision is based on their substantial and complementary contributions throughout the research process. Zeng Y played a pivotal role in the initial conception and design of the study, actively participated in data interpretation, and made significant revisions to the manuscript. Su SH, as the principal investigator, supervised the entire project, provided essential clinical guidance, and ensured the accuracy and integrity of the surgical procedures and data collection. Both authors contributed equally to the coordination of the research, the critical review of the findings, and the final approval of the manuscript. Their collaborative leadership reflects a shared responsibility for the overall work, and all co-authors have consented to this designation.
Supported by Key Project of Jinhua Science and Technology Bureau of Zhejiang Province, No. 2024-3-079.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Jinhua People’s Hospital, Approval No. 2025001.
Informed consent statement: Informed consent was obtained from all participants. All methods were carried out in accordance with relevant guidelines and regulations.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Sheng-Hui Su, MD, Department of Orthopedics, Ningbo No. 2 Hospital, Wenzhou Medical University, No. 41 Northwest Street, Haishu District, Ningbo 315000, Zhejiang Province, China. sushenghui27@163.com
Received: February 3, 2026
Revised: February 25, 2026
Accepted: April 15, 2026
Published online: June 18, 2026
Processing time: 134 Days and 4.8 Hours
Revised: February 25, 2026
Accepted: April 15, 2026
Published online: June 18, 2026
Processing time: 134 Days and 4.8 Hours
Core Tip
Core Tip: This retrospective study of 146 patients explored hidden blood loss (HBL) during dual-media spinal endoscopy (DME) for lumbar spinal stenosis. HBL was calculated using Nadler’s formula and hematocrit (Hct) changes, and risk factors were analyzed by correlation and regression methods. HBL accounted for the majority of total blood loss (TBL) in DME. Operating time, TBL, preoperative Hct and hemoglobin were independent risk factors for HBL. Activated partial thromboplastin time and fibrinogen were also correlated with HBL. Clarifying these factors aids perioperative blood management.