Safety and Efficacy of an Intravenous Unit Dose of Tranexamic Acid in Posterior Lumbar Interbody Fusion

Abstract

Background: Posterior lumbar interbody fusion (PLIF) is a common treatment for degenerative disorders of the lumbar region. The purpose of this research was to evaluate the effectiveness and safety of a single intravenous dosage of tranexamic acid (TXA) in patients with PLIF. Methods: We conducted a retrospective analysis of 61 patients with degenerative lumbar diseases treated with PLIF between January 2021 and November 2021. There were 40 patients in the observation group who received an intravenous unit dose of TXA (1 g/100 mL) after general anesthesia and 15 minutes before incision. The control group consisted of 21 patients who received 100 mL of normal saline. Details pertaining to the surgery time, intraoperative hemorrhage, postoperative drainage, blood transfusion rates, adverse events, and postoperative hospital stays of patients in the two groups were recorded. Additionally, the hemoglobin (Hb), platelet (PLT), activated partial thromboplastin time (aPTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), and D-dimer were recorded on the first and fourth days post-surgery. Results: All surgeries were completed successfully. The surgery time, intraoperative hemorrhage, postoperative drainage, and blood transfusion rates of patients in the observation group were significantly lower than those in the control group (p < 0.05). The D-dimer in the observation group was significantly lower than that in the control group on postoperative day 1 (p < 0.05), while there was no difference on postoperative day 4 (p > 0.05). There were no statistical differences in aPTT, PT, TT, Fg, Hb, PLT, or postoperative hospital stays between the two groups on postoperative day 1 and postoperative day 4 (p > 0.05). Conclusions: In this study, we found that an intravenous unit dose of TXA in PLIF did not affect blood coagulation function and was safe; it was effective in reducing perioperative hemorrhage and blood transfusion rates.