Objective: The purpose of this study is to determine the efficacy and safety of combined intravenous and topical use of tranexamic acid (TXA) in patients undergoing separation surgery for thoracolumbar spinal metastases by evaluating perioperative blood loss and complications.
Methods: 54 patients with thoracolumbar spinal metastases who received separation surgery in our hospital from 2021 to 2024 were retrospectively analyzed and divided into three groups according to the use of TXA. Combined use of TXA group included 20 patients, intravenous TXA group contained 18 patients, 16 cases received no TXA. The evaluation indexes included perioperative blood loss, hematological parameters, surgical time, drain days, perioperative transfusions, and the presence of complications.
Results: During separation surgery for thoracolumbar spine metastasis, TXA decreased the perioperative blood loss significantly (p < 0.001). Compared with TXA infusion alone, combined usage of TXA reduced postoperative blood loss significantly (p < 0.001). The drain days was 4.00±1.55, 5.50±1.56 and 8.50±2.81 respectively, which showed obvious decline in group A and B (p < 0.001). TXA showed conspicuous effect on intraoperative transfusion rate. No complications happened except one patient experienced respiratory aspiration in group B.
Conclusions: The application of TXA in separation surgery of spinal metastases can obviously reduce drain days, perioperative blood loss, intraoperative transfusion rate. The combination of intravenous infusion and topical use of TXA is more effective than intravenous alone, which showed a strong synergistic effect, meanwhile, it does not increase the risk of venous thromboembolism and wound infection.
Keywords: Blood loss; Separation surgery; Spinal metastasis; Spine surgery; Tranexamic acid.
Copyright © 2024. Published by Elsevier Inc.