BACKGROUND: Methods to reduce the amount of blood transfusion include perioperative hemodilution, hypotensive anesthesia, the transfusion of previously deposited autologous blood, and intraoperative autotransfusion used the cell saver. The purpose of this study is to evaluate the effect of the use of the cell saver in orthopedic spinal surgery. METHODS: One hundred and one patients for orthopedic spinal surgery were involved in this study and divided into two groups: group 1 (no used cell saver, n=51) and group 2 (used cell saver, n=50). We checked transfusion amounts during operation and the changes of hematocrit after operation. RESULTS: The amount of blood obtained from cell saver apparatus was 1220 +/- 651 ml (mean SD). Hematocrit of the autologous blood from this apparatus was 48.5 +/- 2.5%. Amounts of blood transfusion during operation were 4.1 +/- 0.9 IU (400 ml/IU) in group 1 and 2.5 +/- 0.7 IU in group 2 (p<0.05). The hematocrit was markedly decreased at the postoperative 2 and 3 days in group 2 (p<0.05). CONCLUSIONS: This study suggested that intraoperative salvage technique with cell saver apparatus could decrease the use of bank blood by 40% in orthopedic spinal surgery. However, we should be prepare the blood for the decrease of the hematocrit at the postoperative 2 and 3 days.