Clinical Research of Combined Intravenous Administration and Topical Application of Tranexamic Acid to a Surgical Wound During Posterior Lumbar Fusion.
BACKGROUND
The safety and effectiveness of combined intravenous and topical administration of tranexamic acid (TXA) on the reduction of blood loss in patients undergoing posterior lumbar fusion are not yet clear. The study aimed to investigate the safety and effectiveness of the combined intravenous and topical administration of TXA on the reduction of blood loss in patients undergoing posterior lumbar fusion.


METHOD
One hundred and eighteen patients who underwent double-segment posterior lumbar decompression and fusion from February 2014 to May 2016 in our hospital were retrospectively reviewed. Patients were divided into two groups, the experimental group and the control group. Preoperative demographics, operative parameters, and adverse effect were recorded and compared.


RESULTS
Intraoperative blood loss, postoperative 24-hour drainage volume, and blood transfusion ratio and volume were significantly lower in the experimental group than in the control group (P < .01); on postoperative 24 hours and 48 hours, hemoglobin and hematocrit levels were significantly higher in the experimental group than in the control group (P < .01). Prothrombin time and fibrinogen content were not significantly different between the 2 groups. The postoperative length of hospital stay was shorter in the experimental group than in the control group (P < .01). No postoperative thrombotic events were reported in either group.


CONCLUSIONS
Combined intravenous and topical administration of TXA seems to be effective and safe in reducing allogenic blood transfusion and blood loss in double-segment posterior lumbar decompression and fusion surgery.
['Ou|Yufu|Y|', 'Wei|Jianxun|J|', 'Li|Rongzhu|R|', 'Liang|Bin|B|', 'Qiu|Dezan|D|', 'Wei|Minke|M|', 'Mu|Xiaoping|X|', 'Li|Zhuhai|Z|']
D061605:Administration, Intravenous D000287:Administration, Topical D000368:Aged D000933:Antifibrinolytic Agents D016063:Blood Loss, Surgical D001803:Blood Transfusion D005260:Female D006801:Humans D008159:Lumbar Vertebrae D008297:Male D008875:Middle Aged D019106:Postoperative Hemorrhage D012189:Retrospective Studies D013123:Spinal Fusion D014148:Tranexamic Acid
tranexamic acid posterior lumbar fusion blood loss blood transfusion gelatin sponge