Our Summary

Tranexamic acid (TXA) is a drug that helps control bleeding during surgery. This study looked at the use of TXA in spinal deformity surgery, comparing it to a placebo and to TXA given through an IV.

The researchers reviewed a large number of studies, covering 609 patients from 1970 to 2019. They found that patients treated with TXA had less blood loss after surgery, higher levels of red blood cells, shorter operation times, lower rates of blood transfusion, less fluid from surgical drains, and shorter hospital stays compared to the control group.

However, there was no significant difference between the two groups in terms of blood loss during surgery and complications.

Interestingly, lower doses of TXA were more effective at reducing blood loss after surgery compared to higher doses. This research supports the use of TXA as an effective and safe treatment in spinal deformity surgery.

FAQs

  1. What is Tranexamic acid (TXA) and what is its role in spinal deformity surgery?
  2. How does the use of TXA compare to a placebo or IV administration in terms of patient outcomes following spinal deformity surgery?
  3. What were the findings regarding the dosage of TXA and its effectiveness in reducing blood loss after surgery?

Doctor’s Tip

It is important to discuss the use of TXA with your doctor before undergoing spinal surgery to see if it is a suitable option for you. It may help reduce blood loss during the procedure and improve your recovery process. Be sure to follow your doctor’s recommendations for medication dosages and post-operative care to achieve the best possible outcome.

Suitable For

Patients who may be recommended for spinal surgery include those with spinal deformities, such as scoliosis or kyphosis, spinal fractures, spinal stenosis, herniated discs, spinal tumors, or degenerative disc disease. Patients who have not had success with conservative treatments such as physical therapy, medication, or injections may also be candidates for spinal surgery. Additionally, patients with severe and persistent symptoms such as numbness, weakness, or pain that significantly impact their daily activities and quality of life may be recommended for spinal surgery.

Timeline

Before spinal surgery, a patient will typically undergo a series of consultations with their surgeon to discuss the procedure, risks, and potential outcomes. They may also undergo pre-operative testing such as blood work, imaging scans, and physical exams.

On the day of surgery, the patient will be admitted to the hospital and prepared for the procedure. The surgery itself can vary in length depending on the type of spinal surgery being performed.

After surgery, the patient will be closely monitored in the recovery room before being transferred to a hospital room. They will likely experience some pain and discomfort, which will be managed with pain medication.

Over the following days, the patient will work with physical therapists to begin the rehabilitation process. They may also need to gradually increase their activity level and follow post-operative instructions to aid in healing and recovery.

Overall, the timeline for a patient before and after spinal surgery can vary depending on the specific procedure and individual factors, but typically involves pre-operative preparation, the surgery itself, immediate post-operative care, and rehabilitation.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery and the use of tranexamic acid (TXA) include:

  1. What is tranexamic acid and how does it help control bleeding during spinal surgery?
  2. Are there any potential side effects or risks associated with using TXA during spinal surgery?
  3. How will the use of TXA impact my recovery after spinal surgery?
  4. Are there any specific factors or conditions that would make me a good candidate for TXA during spinal surgery?
  5. How does the dosage of TXA impact its effectiveness in reducing blood loss during spinal surgery?
  6. What are the potential benefits of using TXA compared to not using it or using a placebo?
  7. How will the use of TXA affect my overall outcome and recovery from spinal deformity surgery?
  8. Are there any alternative treatments or medications that could be used instead of TXA for controlling bleeding during spinal surgery?
  9. Will I need to undergo any additional monitoring or follow-up care due to the use of TXA during spinal surgery?
  10. Can you provide me with more information or resources about the use of TXA in spinal deformity surgery to help me make an informed decision?

Reference

Authors: Fatima N, Barra ME, Roberts RJ, Massaad E, Hadzipasic M, Shankar GM, Shin JH. Journal: Neurosurg Rev. 2021 Feb;44(1):163-175. doi: 10.1007/s10143-020-01236-z. Epub 2020 Jan 14. PMID: 31938967