Introduction

Tranexamic acid (TXA) is well-established as an antibrinolitic

agent commonly used in major orthopedic surgery. However
the frequency of postoperative complications in spine fusion
surgery due to the use of TXA has not been well documented.
Results
TXA Non TXA
TXA Non TXA
TXA Non TXA
TXA Non TXA
Postoperative anemization (g/dl)
Blood units



Material & Methods
- Prospectively study
- n = 59 patients underwent posterior spinal fusion.
- Statistical analysis: bivariate and a logistic regression model
Intravenous tranexamic acid protocol
1st: 10 minutes before skin incision: 10-15mg/kg bolus
2nd: Until the end of the intervention: 2 mg / Kg /h continuous
infusion
TXA Non- TXA
Sex
Age
BMI
ASA
Charlson
Diagnosis
Levels
instrumented
Type of surgery
Operative time
Independent Variables
Perioperative complications
Intrapostoperative blood loss
Transfusion requirements
Local and systemics complications
Hospital lenght stay
Dependent variables
Figure 1: Seroma Figure 2: Seroma
Conclusions



The use of intravenous tranexamic acid in spinal fusion
surgery increases the frequency of postoperative seroma
41,17% vs 14,3%
with a statistically signicant difference (p = 0,039)
Theres differences between both groups regard to:
Increase hospital length stay
Reduction blood loss transfusion requirements
Reduction intraoperative blood loss
References
Aguilera-Roig X, Jordn-Sales M, Natera-Cisneros L et al. cido tranexmico en ciruga ortopdica. Rev Esp Cir Ortop Traumatol 2014;58:52- 6.
Li ZJ, Fu X, Xing D,et al. Is tranexamic acid effective and safe in spinal surgery? A meta-analysis of randomized controlled trials. Spine J. 2013 Sep;22(9):1950-7.
Yang B, Li H, Wang D et al. Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery. PLoS One. 2013;8(2)
Farrokhi MR, Kazemi AP, Eftekharian HR, et al. Efcacy of prophylactic low dose of tranexamic acid in spinal xation surgery: a randomized clinical trial. J Neurosurg Anesthesiol. 2011 Oct;23(4):290-6.
Tse EY, Cheung WY, Ng KF et al. Reducing perioperative blood loss andallogeneic blood transfusion in patients undergoing major spine surgery. J BoneJoint Surg Am. 2011 Jul 6;93(13):1268-77
Shapiro F,Zurakowski D, Sethna NF. Tranexamic acid diminishes intraoperative blood loss and transfusion in spinal fusions for duchenne muscular dystrophyscoliosis. Spine (Phila Pa 1976). 2007 Sep 15;32(20): 2278-83
Wong J, El Beheiry H, Rampersaud YR et al. Tranexamic Acid reduces perioperative blood loss in adult patients having spinal fusion surgery. Anesth Analg. 2008 Nov;107(5):1479-86
Elwatidy S, Jamjoom Z, Elgamal E, et al A.Efcacy and safety of prophylactic large dose of tranexamic acid in spine surgery: a prospective, randomized, double-blind, placebo-controlled study. Spine (Phila Pa 1976).
2008 Nov 15;33(24): 2577-80.
Efcacy and safety of tranexamic acid in spinal fusion surgery
Cervn A.M, Pascual F.J. Rodrguez J.M , Ortega J.A. Andrs-Cano P, Guerado E.
Departament of Orthopedic Surgery. Hospital Costa del Sol, University of Mlaga. Marbella. Mlaga. Spain.
Objective
To determinate if intravenous tranexamic acid is a modicable
risk factor in:
Development of perioperative complications
Hospital length stay
TXA Non TXA
Seroma
Surgical site
infection
Reintervention
Urinary tract
infection
Deep vein
thrombosis
p = 0,671
p = 0,476 p = 0, 721