TY - JOUR
T1 - The effectiveness of tranexamic acid on operative and perioperative blood loss in long-segment spinal fusions
T2 - A consecutive series of 119 primary procedures
AU - Pernik, Mark N.
AU - Dosselman, Luke J.
AU - Aoun, Salah G.
AU - Walker, Adrienne D.
AU - Hall, Kristen
AU - Reyes, Valery Peinado
AU - McDonagh, David L.
AU - Bagley, Carlos A.
N1 - Publisher Copyright:
©AANS 2020, except where prohibited by US copyright law
PY - 2020/5
Y1 - 2020/5
N2 - OBJECTIVE The aim of this study was to determine if the use of tranexamic acid (TXA) in long-segment spinal fusion surgery can help reduce perioperative blood loss, transfusion requirements, and morbidity. METHODS In this retrospective single-center study, the authors included 119 consecutive patients who underwent thoracolumbar fusion spanning at least 4 spinal levels from October 2016 to February 2019. Blood loss, transfusion requirements, perioperative morbidity, and adverse thrombotic events were compared between a cohort receiving intravenous TXA and a control group that did not. RESULTS There was no significant difference in any measure of intraoperative blood loss (1514.3 vs 1209.1 mL, p = 0.29) or transfusion requirement volume between the TXA and control groups despite a higher number of pelvic fusion procedures in the TXA group (85.9% vs 62.5%, p = 0.003). Postoperative transfusion volume was significantly lower in TXA patients (954 vs 572 mL, p = 0.01). There was no difference in the incidence of thrombotic complications between the groups. CONCLUSIONS TXA appears to provide a protective effect against blood loss in long-segment spine fusion surgery specifically when pelvic dissection and fixation is performed. TXA also seems to decrease postoperative transfusion requirements without increasing the risk of adverse thrombotic events.
AB - OBJECTIVE The aim of this study was to determine if the use of tranexamic acid (TXA) in long-segment spinal fusion surgery can help reduce perioperative blood loss, transfusion requirements, and morbidity. METHODS In this retrospective single-center study, the authors included 119 consecutive patients who underwent thoracolumbar fusion spanning at least 4 spinal levels from October 2016 to February 2019. Blood loss, transfusion requirements, perioperative morbidity, and adverse thrombotic events were compared between a cohort receiving intravenous TXA and a control group that did not. RESULTS There was no significant difference in any measure of intraoperative blood loss (1514.3 vs 1209.1 mL, p = 0.29) or transfusion requirement volume between the TXA and control groups despite a higher number of pelvic fusion procedures in the TXA group (85.9% vs 62.5%, p = 0.003). Postoperative transfusion volume was significantly lower in TXA patients (954 vs 572 mL, p = 0.01). There was no difference in the incidence of thrombotic complications between the groups. CONCLUSIONS TXA appears to provide a protective effect against blood loss in long-segment spine fusion surgery specifically when pelvic dissection and fixation is performed. TXA also seems to decrease postoperative transfusion requirements without increasing the risk of adverse thrombotic events.
KW - Long-segment fusion
KW - Operative blood loss
KW - Operative transfusion
KW - Spine surgery safety
KW - Tranexamic acid
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U2 - 10.3171/2019.11.SPINE191174
DO - 10.3171/2019.11.SPINE191174
M3 - Article
C2 - 31978874
AN - SCOPUS:85084148422
SN - 1547-5654
VL - 32
SP - 768
EP - 774
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 5
ER -