scholarly journals The efficacy and safety of tranexamic acid in reducing perioperative blood loss in patients with multilevel thoracic spinal stenosis

Medicine ◽  
2018 ◽  
Vol 97 (50) ◽  
pp. e13643 ◽  
Author(s):  
Peng Xue ◽  
Junsong Yang ◽  
Xiaozhou Xu ◽  
Tuanjiang Liu ◽  
Yansheng Huang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Spinal Stenosis ◽  
Efficacy And Safety ◽  
Perioperative Blood Loss ◽  
Thoracic Spinal Stenosis ◽  
Thoracic Spinal

Efficacy and safety of intra-articular versus intravenous tranexamic acid in reducing perioperative blood loss in total knee arthroplasty

2018 ◽  
Vol 100-B (2) ◽  
pp. 152-160 ◽  
Author(s):  
K. N. Subramanyam ◽  
P. Khanchandani ◽  
P. V. Tulajaprasad ◽  
J. Jaipuria ◽  
A. V. Mundargi
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Efficacy And Safety ◽  
Perioperative Blood Loss ◽  
Total Knee

Aims The aims of this study were to compare the efficacy and safety of intra-articular and intravenous (IV) tranexamic acid (TXA) in controlling perioperative blood loss in total knee arthroplasty (TKA) using a randomized, double-blinded equivalence trial. Patients and Methods A total of 182 patients aged between 45 and 75 years undergoing unilateral TKA at a tertiary centre were randomized to receive TXA, either 1.5 g intra-articularly after closure of the wound (n = 91) or two doses of 10 mg/kg IV (n = 91). The primary outcome measure was the reduction in the level of haemoglobin (Hb) in the blood on the fifth postoperative day. Secondary outcome measures were the total, visible, and hidden blood losses (TBL, VBL, HBL). We assumed equivalence of the primary outcome in both routes with a margin of ± 0.35gm/dl. Block randomization using computer-generated random numbers was used. The patients and the assessor of outcome were blinded. Results All patients completed the study. The mean difference in the reduction of the level of Hb between the two groups was -0.0055 gm/dl, with two-sided 95% confidence interval (CI) being -0.29 to 0.27, well within the predefined equivalence margin of ± 0.35gm/dl. The groups were comparable with regard to TBL, VBL, HBL, and complications. No patient needed a blood transfusion. Conclusion A single intra-articular dose and two IV doses of TXA give equivalent efficacy and safety in the management of blood loss at TKA. Cite this article: Bone Joint J 2018;100-B:152–60.

scholarly journals Efficacy and Safety Analysis of Ultrasonic Bone Curette in the Treatment of Thoracic Spinal Stenosis

2019 ◽  
Vol 11 (6) ◽  
pp. 1180-1186
Author(s):  
Xiang‐dong Lu ◽  
Yi‐bo Zhao ◽  
Xiao‐feng Zhao ◽  
De‐tai Qi ◽  
Xu Yang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Safety Analysis ◽  
Efficacy And Safety ◽  
Thoracic Spinal Stenosis ◽  
Thoracic Spinal

scholarly journals Ultrasonic bone scalpel for thoracic spinal decompression: case series and technical note

2020 ◽  
Author(s):  
Chuiguo Sun ◽  
Guanghui Chen ◽  
Tianqi Fan ◽  
Weishi Li ◽  
Zhaoqing Guo ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Blood Loss ◽  
Operating Procedure ◽  
Spinal Stenosis ◽  
Standard Operating Procedure ◽  
Decompression Surgery ◽  
Spinal Decompression ◽  
Thoracic Spinal Stenosis ◽  
Thoracic Spinal ◽  
Standard Operating

Abstract Background: Thoracic spinal stenosis (TSS) is a rare but intractable disease that fails to respond to conservative treatment. Thoracic spinal decompression, which is traditionally performed using high-speed drills and kerrison rongeurs, is a time-consuming and technically challenging task. Unfavorable outcomes and high incidence of complications are the major concerns. The development and adaptation of ultrasonic bone scalpel (UBS) has promoted its application in various spinal operations, but its application and standard operating procedure in thoracic decompression have not been fully clarified. Therefore, the purpose of this study is to describe our experience and technique note of using UBS, and come up with a standard surgical procedure for thoracic spinal decompression.Methods: A consecutive of 28 patients with TSS who underwent posterior thoracic spinal decompression surgery with UBS between December 2014 and May 2015 were enrolled in this study. Results: Thoracic spinal decompression surgery was successfully carried out in all cases via a single posterior approach. The mean operative time of single-segment laminectomy was 3.0±1.4min and the blood loss was 108.3±47.3ml. In circumferential decompression, the average blood loss was 513.8±217.0ml. Two cases of instrument-related nerve root injury occurred during operation and were cured by conservative treatment. Six patients have experienced cerebrospinal fluid (CSF) leakage postoperatively, but no related complications were observed. Conclusions: The UBS is an optimal instrument for thoracic spinal decompression, and its application enables surgeons to decompress the thoracic spinal cord safely and effectively. This standard operating procedure is expected to help achieve favorable outcomes, and can be used to treat various pathologies leading to thoracic spinal stenosis.

scholarly journals Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hui Wang ◽  
Longjie Wang ◽  
Zhuoran Sun ◽  
Shuai Jiang ◽  
Weishi Li
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Hospital Readmission ◽  
Spinal Epidural Hematoma ◽  
Control Group ◽  
Unplanned Readmission ◽  
Thoracic Spinal Stenosis ◽  
Thoracic Spinal ◽  
Causative Factors ◽  
Csf Leakage

Abstract Background To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS). Methods Hospital administrative database was queried to identify patients who underwent surgical treatment of TSS from July 2010 through December 2017. All unplanned readmissions within 90 days of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Patients of unplanned readmission were matched 1:3 to a control cohort without readmission. Results Twenty-one patients (incidence of 1.7 % in 1239 patients) presented unplanned hospital readmission within a 90-day period and enrolled as the study group, 63 non-readmission patients (a proportion of 1: 3) were randomly selected as the control group. Causes of readmission include pseudomeningocele (8 patients; 38 %), CSF leakage combined with poor incision healing (6 patients; 29 %), wound dehiscence (2 patient; 9 %), surgical site infection (2 patients; 9 %), spinal epidural hematoma (1 patient; 5 %), inadequate original surgical decompression (2 patients; 9 %). Mean duration from re-admission to the first surgery was 39.6 ± 28.2 days, most of the patients readmitted at the first 40 days (66.7 %, 14/21 patients). When compared to the non-readmitted patients, diagnosis of OPLL + OFL, circumferential decompression, dural injury, long hospital stay were more to be seen in readmitted patients. Conclusions The incidence of 90-day unplanned readmission after surgical treatment for TSS is 1.7 %, CSF leakage and pseudomeningocele were the most common causes of readmission, the peak period of readmission occurred from 10 to 40 days after surgery, patients should be closely followed up within this period.

Tranexamic Acid in Thoracic and Lumbar Fusions and Perioperative Blood Loss

2019 ◽  
Vol 32 (10) ◽  
pp. E462-E468 ◽  
Author(s):  
Nathan Wanderman ◽  
William Robinson ◽  
Bayard Carlson ◽  
Mohamad Bydon ◽  
Brad Currier ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Perioperative Blood Loss
Sign in / Sign up

Export Citation Format

Share Document