Efficacy of Tranexamic Acid on Blood Loss in Thoracolumbar Spinal Fusion Surgery

To investigate the effectiveness of topical tranexamic acid (TXA) use on bleeding and drain withdrawal time in adult patients undergoing thoracolumbar fusion surgery.

Cross-sectional comparative study.

Zonguldak Bülent Ecevit University Hospital, Zonguldak, Turkey, from January 2019 to August 2020.

The data of patients, who received thoracic and/or lumbar fusion surgery, were evaluated. The patients were divided into two groups as Group A (30 patients) in which 1 g topical TXA was applied to the surgical site at the end of the surgery; and Group B (30 patients) who did not receive this medication.

The body mass index (BMI) and the patients' demographic factors were similar in both the groups. There were no statistically significant differences between the two groups in terms of the surgical time and level, perioperative ES and FFP transfusion rates (p >0.05). While the amount of perioperative bleeding was almost the same (650 mL, p = 0.778), the amount of postoperative bleeding was lower in Group A (138.1 ± 55.6 mL) in comparison to Group B (230.3 ± 65.4 mL). Postoperative ES transfusion was performed on two patients in Group A (6.7%) and six patients in Group B (30%) (p = 0.02). Accordingly, the mean drain withdrawal time in Group A was 3 (2.8-3.0); days, and in Group B, this time was 6 (5.0-6.0) days (p <0.001). Systemic side effects, especially thromboembolism, were not observed in any of the patients.

The topical use of TXA in spinal fusion surgery reduced perioperative blood loss. Key Words: Blood loss, Thoracolumbar spinal surgery, Tranexamic acid.