Introduction: The field of instrumented spinal procedures is associated with substantial blood
volume losses, which is one of the major hazards we encounter; this would lead to
a greater need for blood products transfusions. The frequent use of these products
can have negative consequences due to body fluid shifting, and donor-host rejection.
Thus, it has become mandatory to establish strategies to maintain blood volume and
minimize losses. Several strategies have been approved to control the disproportionate
blood loss. Objective: This study aims to assess the effectiveness of tranexamic acid in reducing intraoperative
bleeding during our spine instrumented surgeries, while addressing complications associated.
Methods: In this retrospective analysis was steered of 153- consecutive patients treated in
the neurosurgical- spine unit of King Hussein hospital, King Hussein Medical Center
(KHMC), between April 2017 to January 2020, patients who underwent instrumented surgery
for different spinal pathologies at our institute were reviewed. Results: During the analysis period, 153-patients who underwent interbody fusion, were allocated
into two groups. The mean instrumented segments were 2.8 level (range 1-5 levels).
The demographical data of patients of both groups analyzed. The mean span of operating
time was (212.74 ± 41.85 min) for group I, while for the control group mean length
was (208.09min ±42.03). Study showed that the mean drop in the hemoglobin concentration
postoperatively was statistically significant comparing the two groups. Analysis of
blood volume in suction container showed that group I had: 470 ml ±153.06 ml; while
in control group volume was: 1560 ml ± 567.59 ml, which showed significant difference
(p = 0.002). Comparing the drainage volumes at 12 hours postoperatively displayed
no statistically significant differences (p = 0.69) concerning the two groups. Minor
adverse effects allied with the tranexamic acid administration. Conclusions: In summary, perioperative bleeding deemed one of the most important threat for patients.
Tranexamic acid is proved excellent in controlling perioperative bleeding, harboring
few contraindications. Future large studies are still needed to elaborate on unanswered
issues.
Key-words:
Antifibrinolytics - fibrinolysis - instrumented spine - intraoperative bleeding -
tranexamic acid
