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The efficacy and safety of topical administration of tranexamic acid in spine surgery: a meta-analysis
Luo W, Sun RX, Jiang H, Ma XL
Journal of Orthopaedic Surgery. 13(1):96, 2018 Apr 24.. 2018;13((1):):96
Abstract
BACKGROUND 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. METHODS Potentially 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. RESULTS Three 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. CONCLUSIONS The 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.