The effectiveness of tranexamic acid on operative and perioperative blood loss in long-segment spinal fusions: A consecutive series of 119 primary procedures

Mark N. Pernik, Luke J. Dosselman, Salah G. Aoun, Adrienne D. Walker, Kristen Hall, Valery Peinado Reyes, David L. McDonagh, Carlos A. Bagley

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)768-774
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume32
Issue number5
DOIs
StatePublished - May 2020

Keywords

  • Long-segment fusion
  • Operative blood loss
  • Operative transfusion
  • Spine surgery safety
  • Tranexamic acid

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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