Abstract
BackgroundWe conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy and safety of tranexamic acid (TXA) in spine surgery.MethodsPotentially relevant academic articles were identified from the Cochrane Library, MEDLINE (1966–2017.11), PubMed (1966–2017.11), Embase (1980–2017.11), and ScienceDirect (1985–2017.11). Secondary sources were identified from the references of the included literature. The pooled data were analyzed using RevMan 5.1.ResultsThree RCTs and one non-RCT met the inclusion criteria. There were significant differences in total blood loss (MD = − 267.53, 95% CI − 373.04 to − 106.02, P < 0.00001), drainage volume (MD = − 157.00, 95% CI − 191.17 to − 122.84, P < 0.00001), postoperative hemoglobin level (MD = 0.95, 95% CI 0.44 to 1.47, P = 0.0003), and length of hospital stay (MD = − 1.42, 95% CI − 1.92 to − 0.93, P < 0.00001). No significant differences were found regarding transfusion requirement, deep vein thrombosis (DVT), pulmonary embolism (PE), wound hematoma, and infection between the two groups.ConclusionsThe present meta-analysis indicated that the topical application of TXA in spinal surgery decreases the total blood loss and drainage volume and preserves higher postoperative hemoglobin level without increasing the risk of DVT infection, hematoma, DVT, and PE.
Highlights
We conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy and safety of tranexamic acid (TXA) in spine surgery
Spinal surgery is associated with significant perioperative blood loss that may lead to acute anemia and lead to serious complications [1]
Inclusion criteria Studies were considered eligible for inclusion if they met the following criteria: (1) patients treated with spine surgery; (2) the intervention used TXA and studies contained a control group; (3) the outcomes included blood loss, blood transfusion, post-operative Hb level, length of hospital stay, peri-operative outcomes, and complications; and (4) the study was a published or unpublished comparative trial (RCTs or non-RCTs)
Summary
We conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy and safety of tranexamic acid (TXA) in spine surgery. Spinal surgery is associated with significant perioperative blood loss that may lead to acute anemia and lead to serious complications [1]. Blood transfusions are often required to correct acute anemia and carry their own risks, such as inducing disease transmission, hemolysis, and anaphylactic reactions [2, 3]. Various studies have reported that intravenous application of TXA reduces blood loss and allogenic blood transfusions in spinal surgery without increasing related complications [6,7,8]. Several studies [10,11,12] have reported topical application of TXA in spinal surgery. We conducted a large sample meta-analysis to evaluate the efficacy and safety of
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