A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion
Study Design Prospective, randomized controlled trial. Purpose To evaluate the effect of topically applied tranexamic acid (TXA) on postoperative blood loss of neurologically intact patients with thoracolumbar spine trauma. Overview of Literature Few articles exist regarding the use of topical TXA f...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2019-02-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2018-0125.pdf |
| _version_ | 1811307342001602560 |
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| author | Weera Sudprasert Terdpong Tanaviriyachai Kongtush Choovongkomol Sarut Jongkittanakul Urawit Piyapromdee |
| author_facet | Weera Sudprasert Terdpong Tanaviriyachai Kongtush Choovongkomol Sarut Jongkittanakul Urawit Piyapromdee |
| author_sort | Weera Sudprasert |
| collection | DOAJ |
| description | Study Design Prospective, randomized controlled trial. Purpose To evaluate the effect of topically applied tranexamic acid (TXA) on postoperative blood loss of neurologically intact patients with thoracolumbar spine trauma. Overview of Literature Few articles exist regarding the use of topical TXA for postoperative bleeding and blood transfusion in spinal surgery. Methods A total of 57 patients were operated on with long-segment instrumented fusion without decompression. In 29 patients, a solution containing 1 g of TXA (20 mL) was applied to the site of surgery via a drain tube after the spinal fascia was closed, and then the drain was clamped for 2 hours. The 28 patients in the control group received the same volume of normal saline, and clamping was performed using the same technique. The groups were compared for postoperative packed red cells (PRC) transfusion rate and drainage volume. Results The rate of postoperative PRC transfusion was significantly lower in the topical TXA group than in the control group (13.8% vs. 39.3%; relative risk, 0.35; 95% confidence interval, 0.13 to 0.97; p=0.03). The mean total drainage volume was significantly lower in the topical TXA group than in the control group (246.7±125 mL vs. 445.7±211.1 mL, p<0.01). No adverse events or complications were recorded in any patient during treatment over a mean follow-up period of 27.5 months. Conclusions The use of topically administered 1 g TXA in thoracic and lumbar spinal trauma cases effectively decreased postoperative transfusion requirements and minimized postoperative blood loss, as determined by the total drainage volume. |
| first_indexed | 2024-04-13T09:01:37Z |
| format | Article |
| id | doaj.art-f417b9c4e0e84271bf98ce47e9e70a52 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-13T09:01:37Z |
| publishDate | 2019-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-f417b9c4e0e84271bf98ce47e9e70a522022-12-22T02:53:07ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462019-02-0113114615410.31616/asj.2018.0125995A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal FusionWeera SudprasertTerdpong Tanaviriyachai0Kongtush Choovongkomol1Sarut Jongkittanakul2Urawit Piyapromdee3 Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, ThailandStudy Design Prospective, randomized controlled trial. Purpose To evaluate the effect of topically applied tranexamic acid (TXA) on postoperative blood loss of neurologically intact patients with thoracolumbar spine trauma. Overview of Literature Few articles exist regarding the use of topical TXA for postoperative bleeding and blood transfusion in spinal surgery. Methods A total of 57 patients were operated on with long-segment instrumented fusion without decompression. In 29 patients, a solution containing 1 g of TXA (20 mL) was applied to the site of surgery via a drain tube after the spinal fascia was closed, and then the drain was clamped for 2 hours. The 28 patients in the control group received the same volume of normal saline, and clamping was performed using the same technique. The groups were compared for postoperative packed red cells (PRC) transfusion rate and drainage volume. Results The rate of postoperative PRC transfusion was significantly lower in the topical TXA group than in the control group (13.8% vs. 39.3%; relative risk, 0.35; 95% confidence interval, 0.13 to 0.97; p=0.03). The mean total drainage volume was significantly lower in the topical TXA group than in the control group (246.7±125 mL vs. 445.7±211.1 mL, p<0.01). No adverse events or complications were recorded in any patient during treatment over a mean follow-up period of 27.5 months. Conclusions The use of topically administered 1 g TXA in thoracic and lumbar spinal trauma cases effectively decreased postoperative transfusion requirements and minimized postoperative blood loss, as determined by the total drainage volume.http://www.asianspinejournal.org/upload/pdf/asj-2018-0125.pdfTranexamic acidPostoperative hemorrhageSpinal fusionPedicle screwsSpinal injuries |
| spellingShingle | Weera Sudprasert Terdpong Tanaviriyachai Kongtush Choovongkomol Sarut Jongkittanakul Urawit Piyapromdee A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion Asian Spine Journal Tranexamic acid Postoperative hemorrhage Spinal fusion Pedicle screws Spinal injuries |
| title | A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion |
| title_full | A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion |
| title_fullStr | A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion |
| title_full_unstemmed | A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion |
| title_short | A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion |
| title_sort | randomized controlled trial of topical application of tranexamic acid in patients with thoracolumbar spine trauma undergoing long segment instrumented posterior spinal fusion |
| topic | Tranexamic acid Postoperative hemorrhage Spinal fusion Pedicle screws Spinal injuries |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2018-0125.pdf |
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