[ezemljak]

#4456

Is it possible to donate blood for surgery if you are on coumadin? What is the process to prepare for surgery if you are on coumadin because of a history of blood clots? Thank you

[Donald Corenman, MD, DC]

#4457

Surgery when on Coumadin is not advisable unless an emergency. As you already know, Coumadin (Warfarin) interferes with the clotting cascade. This cascade is important to prevent bleeding with injury or if a stomach ulcer exists. Patients on Coumadin most likely have a clotting disorder or have had a previous condition like atrial fibrillation or prior blood clots.

For patients undergoing elective surgery, the normal procedure is to stop Coumadin for about 2-3 days before surgery and start Lovenox- an injectable anticoagulant that has immediate onset and lasts 12 hours. This is then used for 2-3 days until the Coumadin has worn off and then the Lovenox is discontinued. 12 hours after being discontinued, surgery is performed. For spine surgery, normally Lovenox is started 24-36 hours after surgery. There is still a risk of bleeding at the surgery site.

Donating blood prior to surgery while on Coumadin is not generally recommended unless a serious reason is present for the need for blood.

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[ezemljak]

#4459

Thank you for the response. Can a discogram be performed while on Coumadin?

[Donald Corenman, MD, DC]

#4461

Any spinal injection should not be performed with anticoagulation. The risk of bleeding in the canal is increased which can cause significant pressure and possible nerve injury. Discograms are included in the list of spinal injections.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[atierney77]

#6433

Hi. I wanted to ask what you would do if there is a fracture to the C2 and the person is on coumadin. Would you stop it all together or would you use Lovenox? What is the short term way to address this?

[Donald Corenman, MD, DC]

#6436

If the patient is on anti-coagulation with some exceptions, the anti-coagulation should be stopped prior to surgery. Normally if the patient is on Coumadin, the Coumadin is stopped 3-4 days prior to surgery and the patient is placed on Lovenox. The Lovenox is stopped 12-24 hours prior to spine surgery and started 24-48 hours after surgery.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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