We have treated patients who object to receiving blood products during their spinal care. For these patients, the issues regarding re-infusion of their own blood or another person’s blood are a serious concern. Patients who have religious convictions regarding blood products are welcome in our practiceWe respect the patient’s right to choose and will attempt to provide care, including spinal surgery, for these patients on a case-by-case basis. In these circumstances, we seek to meet the challenge of providing care to all patients, even those with complicated care issues. Frequently, we can discuss various techniques to provide the patient their own blood during the surgery. One of these techniques includes hemodilution. During the procedure of normovolemic hemodilution, the patient’s blood is replaced with a non-blood fluid keeping the patient’s blood in a circuit constantly linked to the patient’s system. This blood can be returned to the patient at the end of the procedure. As well, there are numerous autologous blood salvage techniques, such as cell saver, where the patient’s blood is collected during the operation, it travels out of the patient’s body and is later reinfused back into the patient. During this intraoperative collection, there is a brief period of storage with later reinfusion providing the patient with blood to sustain the patient’s life. In addition there are synthetic hormones, such as recombinant human erythropoietin, which may be given to a patient to stimulate the bone marrow to produce more red blood cells prior to surgery and after surgery. During the surgery, there are also techniques such as biologic products (for example, cellulose thrombin mixtures which can be applied to decrease blood loss during the surgery). Surgery can result in significant blood loss. For this reason, we take patients on a case-by-case basis and decide if we can work with the patient to provide them spinal care in accordance with their personal and religious beliefs.