Marijuana Use is Not a Contraindication for Tranexamic Acid Utilization in Lumbar Spine Surgery

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Pharmacology

Background:

• Spinal fusion surgery carries risks of blood loss and complications.
• Tranexamic acid (TXA) is used to reduce bleeding during surgery.
• The impact of marijuana use on surgical outcomes, particularly with TXA, is not well understood.

Purpose of the Study:

• To evaluate the safety of tranexamic acid (TXA) in patients undergoing lumbar spinal fusion who use marijuana.
• To compare surgical outcomes between marijuana users and non-users receiving TXA during lumbar fusion.

Main Methods:

• Retrospective cohort study of 294 patients undergoing 1-4 level lumbar fusion.
• Patients were divided into marijuana users (n=146) and non-users (n=146) based on self-report.
• Outcomes assessed included length of stay, blood loss, and various post-operative complications.

Main Results:

• Marijuana users and non-users had similar demographics and levels fused.
• Estimated blood loss and need for transfusion were comparable between groups.
• Thromboembolic events were rare; marijuana users had a lower risk of prolonged length of stay.

Conclusions:

• Marijuana use was not associated with increased complications or blood loss in lumbar spinal fusion patients treated with TXA.
• TXA can be safely utilized in patients undergoing lumbar spine fusion regardless of marijuana usage.
• Marijuana use should not be a contraindication for TXA in this patient population.