scholarly journals Letter to the Editor. Tranexamic acid for reducing intra- and postoperative blood loss in posterior lumbar interbody fusion: Is it safe enough?

2018 ◽  
Vol 29 (2) ◽  
pp. 226-227 ◽  
Author(s):  
Yi-Syuan Li ◽  
Chun-Yu Chen ◽  
Chi-Hui Chen ◽  
Zhi-Kang Yao ◽  
Yu-Hsiang Sung ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Postoperative Blood Loss ◽  
Lumbar Interbody Fusion ◽  
Letter To The Editor

scholarly journals High-dose tranexamic acid reduces intraoperative and postoperative blood loss in posterior lumbar interbody fusion

2017 ◽  
Vol 26 (3) ◽  
pp. 363-367 ◽  
Author(s):  
Junichi Kushioka ◽  
Tomoya Yamashita ◽  
Shinya Okuda ◽  
Takafumi Maeno ◽  
Tomiya Matsumoto ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Interbody Fusion ◽  
Surgical Techniques ◽  
Posterior Lumbar Interbody Fusion ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
High Dose ◽  
Lumbar Interbody Fusion ◽  
Single Level

OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF). The purpose of the study was to evaluate the efficacy of high-dose TXA in reducing blood loss and its safety during single-level PLIF. METHODS The study was a nonrandomized, case-controlled trial. Sixty consecutive patients underwent single-level PLIF at a single institution. The first 30 patients did not receive TXA. The next 30 patients received 2000 mg of intravenous TXA 15 minutes before the skin incision was performed and received the same dose again 16 hours after the surgery. Intra- and postoperative blood loss was compared between the groups. RESULTS There were no statistically significant differences in preoperative parameters of age, sex, body mass index, preoperative diagnosis, or operating time. The TXA group experienced significantly less intraoperative blood loss (mean 253 ml) compared with the control group (mean 415 ml; p < 0.01). The TXA group also had significantly less postoperative blood loss over 40 hours (mean 321 ml) compared with the control group (mean 668 ml; p < 0.01). Total blood loss in the TXA group (mean 574 ml) was significantly lower than in the control group (mean 1080 ml; p < 0.01). From 2 hours to 40 hours, postoperative blood loss in the TXA group was consistently significantly lower. There were no perioperative complications, including thromboembolic events. CONCLUSIONS High-dose TXA significantly reduced both intra- and postoperative blood loss without causing any complications during or after single-level PLIF.

scholarly journals Tranexamic acid reduce hidden blood loss in posterior lumbar interbody fusion (PLIF) surgery

Medicine ◽  
2020 ◽  
Vol 99 (11) ◽  
pp. e19552
Author(s):  
Derong Xu ◽  
Xin Chen ◽  
Zheng Li ◽  
Zhinan Ren ◽  
Qianyu Zhuang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Hidden Blood Loss

COMPARATIVE STUDY OF UNILATERAL AND BILATERAL CAGES WITH RESPECT TO CLINICAL OUTCOMES AND STABILITY IN INSTRUMENTED POSTERIOR LUMBAR INTERBODY FUSION

Neurosurgery ◽  
2008 ◽  
Vol 63 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Ji-Ho Lee ◽  
Jae Hyup Lee ◽  
Kang-Sup Yoon ◽  
Seung-Baik Kang ◽  
Chris H. Jo
Keyword(s):  
Blood Loss ◽  
Visual Analog Scale ◽  
Oswestry Disability Index ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Postoperative Blood Loss ◽  
Lumbar Interbody Fusion ◽  
Analog Scale ◽  
Fusion Level

ABSTRACT OBJECTIVE We sought to compare the clinical and radiological results of instrumented posterior lumbar interbody fusion (PLIF) using unilateral or bilateral polyetheretherketone cages and pedicle screws. METHODS One hundred eighty-seven cases of degenerative spine that had been followed for at least 18 months were reviewed retrospectively. In 88 cases (147 levels), one cage was inserted, and in 99 cases (152 levels), two cages were inserted. Visual analog scale, Oswestry disability index, and functional rating indices were measured. Lumbar lordosis, lumbar scoliotic and fusion level scoliotic angles, and stable fixation were determined before surgery and 12 months postoperatively on standing x-rays. Amounts of intra- and postoperative blood loss, total quantities transfused, and operation times were also evaluated. RESULTS No significant differences were found between the two groups in terms of visual analog scale, Oswestry disability index, functional rating indices, lumbar lordosis, lumbar scoliotic angles, fusion level scoliotic angles, or fixation stabilities. However, the amounts of postoperative blood loss, total blood loss, and total transfusion for two-level PLIF using a unilateral cage were statistically smaller than those for two-level PLIF using bilateral cages. Times required for PLIF using a unilateral cage were also significantly shorter than those for PLIF using bilateral cages. CONCLUSION Unilateral cage and bilateral pedicle screw insertion may be a good alternative surgical option because it provides adequate alignment, balance, and mechanical stability in addition to reducing operative time, blood loss, and transfusion requirements.

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