Most surgery carries the risk of complications, when the surgery involves the spine and spinal cord, these complications (i.e., uncontrolled bleeding) can be severe, as the development of an epidural hematoma can cause spinal cord compression and irreversible damage to the central nervous system. Bleeding in spine surgery is a common occurrence but when bleeding is uncontrolled the consequences can be severe due to the potential for spinal cord compression and damage to the central nervous system. There are many factors that influence bleeding during spine surgery including patient factors and those related to the type of surgery and the surgical approach to bleeding. There are a range of methods that can be employed to both reduce the risk of bleeding and achieve hemostasis, one of which is the adjunct use of hemostatic agents. Hemostatic agents are available in a variety of forms and materials and with considerable variation in cost, but specific evidence to support their use in spine surgery is sparse.