Can tranexamic acid reduce blood loss in cervical laminectomy with lateral mass screw fixation and bone grafting

Abstract

To assess the safety and efficacy of tranexamic acid (TXA) for decreasing perioperative blood loss in cervical laminectomy with lateral mass screw fixation and bone grafting (CLF), in which all surgical procedures are identical.From November 2014 to April 2016, we performed a retrospective comparative analysis of 119 patients with multilevel cervical spondylotic myelopathy who had undergone a CLF from C3 to C6 in our center. All surgeries were performed on the patients using a consistent, standard procedure. Patients were divided into control (46) and TXA (73) groups according to whether or not they had received TXA treatment before and during surgery. Demographic profiles of patients such as gender, age, body weight, height, and body mass index were collated and differences between the 2 groups compared. Preoperative and postoperative hematological data in addition to intraoperative and postoperative blood loss were compared between the 2 groups. Additionally, any complications of TXA were also evaluated to assess safety.There was no statistically significant difference in demographic traits between the 2 groups. Intraoperative blood loss in the TXA group (179.66 ± 81.45 mL) was significantly lower than that of the control group (269.13 ± 94.68 mL, P < 0.001), as was postoperative blood loss (108.08 ± 44.31 and 132.83 ± 49.39 mL, respectively; P = 0.005). Total blood loss in the TXA group (287.74 ± 115.40 mL) was also significantly lower than that of the control group (401.96 ± 127.88, P < 0.01). No major intraoperative complications occurred in any of the cases.TXA significantly reduced perioperative blood loss in CLF with no major side effects.

The efficacy and safety of topical administration of tranexamic acid in spine surgery: a meta-analysis

“…The intravenous application of TXA has been confirmed as effectively decreasing blood loss and transfusion requirement in spinal surgery [ 6 , 7 ]. Recently, topical TXA is widely established in hip and knee arthroplasty and successfully reduced postoperative blood loss and blood transfusion requirements [ 17 , 18 ].…”

Tisseel's impact on hemostasis for 2–3 and 4–6-level lumbar laminectomies

“…Several studies demonstrated how preoperative intravenous administration of tranexamic acid (TXA) (FS) contributed to hemostasis and reduced postoperative blood loss following spinal surgery [ Table 4 ]. [ 2 7 10 13 14 ]…”

“…(2017) documented TXA effectively promoted hemostasis for 73 patients undergoing cervical laminectomy/lateral mass screw fusion vs. 46 controls; TXA contributed to decreased intraoperative blood loss (179.66 vs. 269.13), postoperative blood loss (108.08 and 132.83), total blood loss (287.74 vs. 401.96), without any major thromboembolic/other complications. [ 13 ]…”

Virulence Factors of Clostridioides (Clostridium) difficile Linked to Recurrent Infections

“…RCDI is more frequent in patients infected with the 027 strain than in those infected with non-027 strains (P < 0.001). Besides, the clinical cure rate has been reported to be lower in 027-infected patients than in those with non- Long persistence/protection of C. difficile [36,[42][43][44][45][46] Accumulation of spores Reduced susceptibility to antibiotics [45,47] SlpA (S-layer protein A)…”