Efficacy and Safety of Topical Use of Tranexamic Acid in Reducing Blood Loss During Primary Lumbar Spinal Surgery

A retrospective case-control study.To compare postoperative blood loss, amount of allogeneic blood transfusion, removal time of drainage tube, length of hospital stay, and complications associated with tranexamic acid (TXA).Spinal fusion surgery can be associated with significant blood loss. To the best of our knowledge, very few published studies exist reporting the effect of topical use of tranexamic acid (tTXA) on decreasing the blood loss in patients undergoing posterior lumbar spinal fusions.We conducted a retrospective nonrandomized case-control study of 100 adults undergoing posterior lumbar spinal fusion surgery. In the tTXA group (n = 50), wound surface was soaked with TXA (1 g in 100 mL saline solution) for 5 minutes before wound closure. In the control group (n = 50), wound surface was soaked with the same volume of normal saline. The postoperative blood loss, removal time of drainage tube, amount of allogeneic blood transfusion, and length of hospital stay were compared between the two groups. And the complications of TXA were also collected.In the tTXA group, the postoperative blood loss, removal time of drainage tube, postoperative length of hospital stay were significantly lower than those in the control group (155.2 ± 104.3 mL vs. 278.6 ± 124.1 mL, 2.0 ± 0.6 d vs. 2.4 ± 0.5 d, 4.7 ± 1.4 d vs. 5.6 ± 2.3 d, P 0.05, respectively). There was no significant difference in blood transfusion between two groups. No significant changes were noticed in terms of coagulation function, and no complications associated with TXA were observed.tTXA can significantly reduce postoperative blood loss, accelerate removal of drainage tube, shorten the duration of hospital stay, while not increasing the complication incidence in patients undergoing posterior lumbar spinal fusion surgery.3.