Are we justified in doing blood tests 'routinely' for all neurosurgical patients? 
To ensure continuing patient care in a cost effective and efficient manner and to determine the importance of routine pre-op bloods in patients undergoing spine surgery, a retrospective audit of 170 patients was carried out in the Neurosurgery Department at Cork University Hospital.  There were 94 males and 76 females.  No test had less than 87.4% normal results.  There were 17 (10.7%) abnormal haemoglobin levels, 13 (8.2%) abnormal white cell count levels, 14 (8.9%) abnormal creatinine levels and of sodium and potassium levels, 5 (3.2%) and 3 (2%) were abnormal respectively.  Of the abnormal results, the majority fell close to reference range.  95% of the total cost incurred in performing the procedure was attributed to normal blood results.  Abnormal blood results in this cohort of patients did not alter management.  We conclude that routine blood tests, including coagulation screen, may not be necessary in healthy individuals undergoing elective spine surgery.