PurposeThis study aimed to evaluate the efficacy and safety of predeposit autologous RBC apheresis (PARA) in patients undergoing multilevel spinal fusion surgery.MethodsA total of 112 patients from January 2020 to June 2022 were divided into two groups according to PARA: the PARA group (n= 51) and the control group (n= 61). The baseline characteristics of the patients, outcomes, transfusion cost, hospitalization cost, length of stay, complications, and changes in hemoglobin and hematocrit levels between the two groups were compared.ResultsThe baseline characteristics were similar in both groups. No significant differences were found in functional outcomes, including VAS score (p= 0.159), ODI score (p= 0.214), JOA score (p= 0.752), and SF-36 score (p= 0.188) between the PARA and control groups. The amount and rate of intraoperative and perioperative allogeneic RBC transfusion were significantly higher in the control group than in the PARA group (p< 0.001). The postoperative (9.04 ± 3.21 vs. 11.05 ± 3.84,p= 0.004) and total length of stay (15.78 ± 3.79 vs. 17.36 ± 4.08,p= 0.038) in the PARA group were significantly lower than those in the control group, respectively. Despite no difference in hospitalization cost (p= 0.737), the total blood transfusion cost in the PARA group was significantly lower, compared with the control group (p< 0.001). For safety evaluation, there were no significant differences in Hb and Hct levels between the two groups at admission, on postoperative day 1, and postoperative day 3, respectively (p> 0.05). Moreover, the number of postoperative infections in the PARA group was significantly lower than that in the control group (p= 0.038).ConclusionPARA was a novel, safe, and highly efficient technique for mass autologous blood preparation in a quite short preparation time. This method could significantly reduce the amount of allogeneic blood transfusion and length of stay, which could provide a theoretical basis for following clinical practice about the technique.