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Bleeding Risk with Ketorolac After Lumbar Microdiscectomy

Scientific Paper

Chin KR1, Sundram HMarcotte P.

Interested medical professionals can read through the full paper, as published in Clinical Spine Surgery, here.


There is a need to improve postoperative analgesia to support the trend to shorter hospitalization after minimally invasive spine surgeries. Ketorolac Tromethamine has proven efficacy in decreasing postoperative pain but there is concern with postoperative epidural bleeding after spine procedures. We prospectively assessed the incidence of bleeding complications after microdiscectomy in patients treated with a single 30 mg intraoperative dose of Ketorolac subsequent to wound closure. Group 1 consisted of 44 patients, 24 women and 20 men with mean age of 35.7 years (20 to 68 y) treated with Ketorolac. Group 2 consisted of 45 patients, 28 men and 17 women with mean age 46.8 years (32 to 74 y), who underwent discectomy without Ketorolac. Postoperative bleeding complications were monitored along with pain levels and time to discharge. We detected no significant postoperative changes in coagulation parameters or bleeding from the surgical site in either group. Both group 1 and 2 had averaged preoperative visual analog scale scores for leg pain of 8. Group 1 had an average postoperative visual analog scale score of 2.6 compared with 4 for group 2 two hours after surgery. Single dose intravenous Ketorolac provided beneficial analgesia without significant increase in risk of bleeding after microdiscectomy, enabling us to consistently perform microdiscectomy as an ambulatory procedure. Meticulous hemostasis should be accomplished before closure. Prolonged postoperative use is a promising alternative to narcotics.


Dr. Kingsley R. Chin, Founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin is a board-certified Harvard-trained Orthopedic Spine Surgeon and Professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Sciences at the University of Technology, Jamaica.

Learn more about Dr. Chin here and connect via LinkedIn.


Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.


The above study utilized Less Exposure Surgery by SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.



Chin KR1, Sundram HMarcotte P.

Author information

  1. Spine Surgery Service, Department of Orthopaedics, University of Pennsylvania Medical School, Philadelphia, PA 19104, USA. [email protected]

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