Reducing postoperative morbidity by diminishing chest tube drainage utilizing tranexamic acid following vertebral body tethering for adolescent idiopathic scoliosis.

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Vertebral body tethering (VBT) is a non-fusion surgical option for adolescent idiopathic scoliosis (AIS) that requires a postoperative (PO) chest tube. This study evaluates whether 48h of PO TXA reduces chest tube (CT) drainage and retention compared to 24h of TXA following VBT for AIS. Consecutively treated patients with a diagnosis of AIS who underwent VBT were assessed. Thirty-eight patients who received 48h of PO IV TXA (48-TXA) were compared to 35 VBT patients who received 24h of PO IV TXA (24-TXA) and 48 patients who did not receive TXA (non-TXA). TXA use in thoracic CT and thoracolumbar CT drainages were also assessed separately. Group comparisons were performed using one-way ANOVA and Chi-square tests. There were no significant differences in demographics between groups. TXA significantly reduced CT drainage (p < 0.001) and retention (p < 0.001), with no differences between 24-TXA and 48-TXA (p = 0.88). Sub-analyses showed that both 24-TXA and 48-TXA reduced thoracic CT drainage (p = 0.002, p = 0.02) and retention time (p = 0.04, p = 0.007) compared to non-TXA, respectively. For thoracolumbar CT, differences were observed only between 24-TXA and non-TXA (p = 0.01, p = 0.03). TXA was an independent predictor of reduced CT drainage (p < 0.001) and retention (p < 0.001). Hospital stay, ICU stay, and complications didn't differ between TXA groups (p > 0.9, p = 0.4), respectively. Intravenous TXA reduces CT drainage and retention after VBT for AIS for thoracic CTs. There was no additional benefit of 48-TXA over 24-TXA in decreasing overall drainage and CT retention time.