Turkish Neurosurgery 2023 , Vol 33 , Num 1
Effect of Topical Administration of Tranexamic Acid on Intraoperative and Postoperative Blood Loss during Posterior Cervical Laminectomy and Fusion Surgery: A Retrospective Study
Masoud KHADIVI1,Sajjad SAGHEBDOUST1,Navid MOGHADAM1,Mohammad ZAREI5,Mersad MOOSAVI3,Hosseinali ATAEI6,Arash JAFARIEH7,Alireza BORGHEI8,Milad SHAFIZADEH2,Mohammad ESLAMIAN2,Morteza Faghih JOUIBARI2,Ramin KORDI1,Mohsen ROSTAMI3
1Tehran University of Medical Sciences, Neuroscience Institute, Sports Medicine Research Center, Tehran, Iran
2Tehran University of Medical Sciences, Shariati Hospital, Department of Neurosurgery,Tehran, Iran
3Tehran University of Medical Sciences, Spine Center of Excellence, Yas Hospital, Tehran, Iran
4Razavi Hospital, Department of Neurosurgery, Mashhad, Iran
5Tehran University of Medical Sciences, Imam Hospital, Department of Orthopedics, Tehran, Iran
6Tehran University of Medical Sciences, Yas Hospital, Department of Anesthesiology, Tehran, Iran
7Tehran University of Medical Sciences, Amiralam Hospital, Department of Anesthesiology, Tehran, Iran
8Rush University Medical Center, Department of Neurosurgery, Chicago, IL, USA
DOI : 10.5137/1019-5149.JTN.37389-21.2 AIM: To assess the role of topical administration of tranexamic acid (TXA) on intraoperative and postoperative blood loss of patients undergoing posterior cervical laminectomy and lateral mass screw ?xation (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 PCLF surgery. These results need further investigation in future studies to draw a definite conclusion. Keywords : Posterior cervical laminectomy, Fusion surgery, Blood loss, Topical tranexamic acid

Corresponding author : Mohsen ROSTAMI, rostamim@tums.ac.ir