Ristagno G, et al. – This analysis assessed the incidence and the cost of red blood cell transfusion in all patients undergoing surgery for spine fusion over a 3-year period in a high-volume center for spine procedures. A total of 1.882 elective spine fusions were performed during the 3-years observation period. Results suggested that several surgical (ie, exposure of cancellous bone, stripping of skeletal muscles, extensive spinal instrumentation, and operative time) and patient factors (ie, age, sex, comorbidities, pre-surgical hemoglobin level) may contribute to perioperative blood loss. Data also indicated that accurate patient blood management may efficiently reduce transfusion requirements and, ultimately, health-care costs.