The effect of tranexamic acid in blood loss and transfusion volume in adolescent idiopathic scoliosis surgery: a single-surgeon experience
- First Online:
- 242 Downloads
Intraoperative blood loss in scoliosis surgery often requires transfusions. Autogenous blood decreases but does not eliminate risks typically associated with allogenic blood transfusion. Costs associated with transfusions are significant. Tranexamic acid (TXA) has been shown to decrease blood loss in cardiac and joint surgery. Few studies have examined its use in pediatric spine surgery, and the results are inconsistent. The aim of this study was to determine whether TXA decreases intraoperative blood loss and transfusion requirements in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion by a single surgeon.
The medical records and operative reports of surgically treated patients with adolescent idiopathic scoliosis between 2000 and 2009 were retrospectively reviewed. The inclusion criteria were: (1) patients who underwent instrumented posterior spinal fusion, (2) had complete medical records, and (3) were treated by the same surgeon. Forty-nine patients who met the inclusion criteria were divided into two groups: Group A (25 patients) received TXA, while Group B (24 patients) did not receive TXA.
After controlling for age at the time of surgery, gender, and number of vertebral levels fused, the mean intraoperative blood loss was significantly lower in Group A (537 ml) than in Group B (1,245 ml) (p = 0.027). The mean volume of blood transfused intraoperatively was 426 and 740 ml for Group A and Group B, respectively. The difference was not statistically significant after controlling for age, gender, and number of levels fused (p = 0.078).
TXA significantly decreased intraoperative blood loss in posterior spinal fusions performed for adolescent idiopathic scoliosis.
KeywordsAdolescent idiopathic scoliosis Tranexamic acid Transfusion Spinal fusion
- 1.Simpson MB, Georgopoulos G, Orsini E et al (1992) Autologous transfusions for orthopaedic procedures at a children’s hospital. J Bone Joint Surg Am 74:652–658Google Scholar
- 5.Dodd RY (2007) Current risk for transfusion transmitted infections. Curr Opin Hematol 14:671–676Google Scholar
- 9.Sculco TP, Gallina J (1999) Blood management experience: relationship between autologous blood donation and transfusion in orthopedic surgery. Orthopedics 22:s129–s134Google Scholar
- 17.Longstaff C (1994) Studies on the mechanisms of action of aprotinin and tranexamic acid as plasmin inhibitors and antifibrinolytic agents. Blood Coagul Fibrinolysis 5:537–542Google Scholar
- 21.Yaniv E, Shvero J, Hadar T (2006) Hemostatic effect of tranexamic acid in elective nasal surgery. Am J Rhinol 20:227–229Google Scholar
- 24.Benoni G, Fredin H (1996) Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty: a prospective, randomised, double-blind study of 86 patients. J Bone Joint Surg Br 78:434–440Google Scholar
- 38.Reid RW, Zimmerman AA, Laussen PC et al (1997) The efficacy of tranexamic acid versus placebo in decreasing blood loss in pediatric patients undergoing repeat cardiac surgery. Anesth Analg 84:990–996Google Scholar