Abstract
Spinal fixation surgery can be associated with postoperative hematoma and excessive bleeding, often requiring allogeneic blood transfusion. Tranexamic acid (TXA) is a synthetic antifibrinolytic drug that prevents the breakdown of fibrin, thereby stabilizing blood clots and reducing blood loss in conditions that promote fibrinolysis. It has been demonstrated that administration of prophylactic TXA in cardiac surgery, total knee arthroplasty, and scoliosis correction reduces perioperative blood loss and transfusion requirements. However, clinical data for the efficacy of TXA in spinal surgery are limited. Therefore, the objective of this study was to evaluate the effect of TXA on perioperative blood loss and the requirement for transfusion of blood products in spinal fixation surgery. Thirty-one patients were allocated randomly to either a TXA group (1,000 mg infused before surgery) or a non-TXA group. Intraoperative and postoperative blood loss was not significantly reduced in the TXA group relative to the non-TXA group. In the TXA group, however, no patient required blood transfusion. There were no complications related to the use of TXA in either group. Although TXA did not have a significant impact on the management of intraoperative and postoperative blood loss in patients undergoing spinal fixation surgery, a large comparative trial is needed to further assess the relative efficacy of TXA in spinal fixation surgery.
