Turkish Neurosurgery
Effect of Topical Administration of Tranexamic Acid on Intraoperative and Post-Operative Blood Loss during Posterior Cervical Laminectomy and Fusion Surgery: A Retrospective Study
Masoud Khadivi1, Sajjad Saghebdoust4, Navid Moghadam3, Mohammad Zarei5, Mersad Moosavi3, Hoseinali Ataei6, Arash Jafarieh7, Alireza Borghei8, Milad Shafizadeh2, Mohammad Eslamian2, Morteza Faghih Jouibari2, Ramin Kordi1, Mohsen Rostami1
1Tehran University of Medical Sciences,, Sports Medicine Research Center, Neuroscience Institute, Tehran,
2Shariati Hospital, Tehran University of Medical Sciences, Department of Neurosurgery, Tehran,
3Yas Hospital, Tehran University of Medical Sciences, Spine Center of Excellence, Tehran,
4Razavi Hospital, Department of Neurosurgery, Mashhad,
5Imam Hospital, Tehran University of Medical Sciences, Department of Orthopedics, Tehran,
6Yas Hospital, Tehran University of Medical Sciences, Department of Anesthesiology, Tehran,
7Amiralam Hospital, Tehran University of Medical Sciences, Department of Anesthesiology, Tehran,
8Rush University Medical Center, Department of Neurosurgery, Chicago,
DOI: 10.5137/1019-5149.JTN.37389-21.2
Aim:Many studies evaluated the effect of systemic tranexamic acid (TXA) administration on blood loss reduction during spine in the past decade. However, topical use of TXA during cervical spine surgery is rarely investigated. The present study was conducted to assess the role of topical administration of TXA on intraoperative and postoperative blood loss of patients undergoing posterior cervical laminectomy and lateral mass screw fixation (PCLF) compared to a control group.Material and Methods:The data of 88 patients that underwent PCLF surgery, including 41 females and 47 males, were included in this retrospective study. Data elements including intraoperative blood loss (IBL), postoperative blood loss (PBL), amount of blood transfusion, surgical time, use of hemostatic agents, length of hospital stay, and time to return to work were extracted from medical records and compared between those who received topical TXA during surgery (irrigation of the surgical field with a solution of 3 g TXA in 100 ml normal saline) and an age- and sex-matched control group.Results:There were 48 patients in the TXA group and 40 patients in the control group. There were no significant differences in the baseline measurements and the level of operation between the two groups. The results showed that IBL and PBL were significantly lower in the TXA group compared to the control group (p= 0.03 and p<0.01, respectively). There were no significant differences in the need for blood transfusion, surgical time, and hospital stay between the two groups (p>0.05). Moreover, the use of hemostatic materials during surgery and the time to return to work were significantly lower in the topical TXA group (P= 0.04 and p<0.01, respectively).Conclusion:Topical TXA efficiently reduces intraoperative and postoperative bleeding in patients undergoing posterior cervical laminectomy and lateral mass screw fixation (PCLF) surgery. These results need further investigation in future studies to draw a definite conclusion.
Corresponding author : Mohsen Rostami