Neurosurgery
Neurosurgery and alpha-gal syndrome (AGS)
Alpha-gal Syndrome and Neurosurgery
There are a number of papers on perioperative care of patients with alpha-gal syndrome, but only a limited number specific to AGS and neurosurgery.
As AGS incidence rises, spine surgeons must recognize high-risk patients, substitute for safe biomaterials when able, and coordinate perioperative care to avoid anaphylaxis. 143
Highlights from
Neurosurgical Management of Patients with Alpha-Gal Syndrome.
Carlstrom LP, Akhter A, Macielak RJ, Callejas CA, Eickstaedt JE, Brooks C, Van Koevering K, Schoo D, Wu KC, Prevedello DM.
July, 2024
The following are excerpts were taken directly from this paper:
Key points
Coming soon.
As AGS incidence rises, spine surgeons must recognize high-risk patients, substitute for safe biomaterials when able, and coordinate perioperative care to avoid anaphylaxis. 143
Highlights from
Complex Spine Surgery in the Setting of Alpha-Gal Syndrome.
Razzaq BW, Passman JN, DiMaria S, Servider J, Kleyner RS, Sacks GI, Bergese S, Mushlin H.
Nov 6, 2025
Investigated
- Common hemostatic agents
- Dural substitutes and
- Grafts
Discussed
- Anesthetic considerations
- Workup and pretreatment of AGS patients
Presented
- An illustrative case of an AGS patient who experienced intraoperative anaphylaxis during a deformity correction surgery.
- A review of 25 commonly used agents.
The following are excerpts were taken directly from this paper:
Key points
- “A review of 25 commonly used agents showed that 64% were potentially unsafe for AGS patients.”
- “In contrast, plant-based polysaccharide powders, oxidized cellulose, human recombinant thrombin, and synthetic dural sealants are safe alternatives.”
- “AGS poses unique risks in spine surgery because the use of many hemostatic, graft, and dural-repair agents that contain mammal products is commonplace.”
- “A structured pathway that includes preoperative allergy consultation, α-gal immunoglobulin E testing, premedication, pharmacy-verified product lists, and real-time team communication can prevent life-threatening reactions.”
- “As AGS incidence rises, spine surgeons must recognize high-risk patients, substitute for safe biomaterials when able, and coordinate perioperative care to avoid anaphylaxis.”
Key Publications
Key papers on alpha-gal syndrome and neurosurgery
See also more general papers on perioperative care of patients with alpha-gal syndrome.
- Razzaq BW, Passman JN, DiMaria S, Servider J, Kleyner RS, Sacks GI, Bergese S, Mushlin H. Complex Spine Surgery in the Setting of Alpha-Gal Syndrome. World Neurosurgery. 2025 Nov 6:124634.
- Carlstrom LP, Akhter A, Macielak RJ, Callejas CA, Eickstaedt JE, Brooks C, Van Koevering K, Schoo D, Wu KC, Prevedello DM. Neurosurgical management of patients with alpha-gal syndrome. Journal of Neurological Surgery Reports. 2024 Jul;85(03):e96-100.