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Thomas J. Buell, Davis G. Taylor, Ching-Jen Chen and Bhiken I. Naik

TO THE EDITOR: We read with great interest the outstanding article by Guan and colleagues 2 ( Guan J, Cole CD, Schmidt MH, et al: Utility of intraoperative rotational thromboelastometry in thoracolumbar deformity surgery. J Neurosurg Spine 27:528–533, November 2017 ). This timely study showed intraoperative rotational thromboelastometry (ROTEM)-guided transfusion for posterior thoracolumbar deformity surgery (≥ 7 levels) significantly reduced total blood product transfusion requirements. However, we were left with unresolved questions. We request clarification