Tranexamic Acid in Reducing Perioperative Blood Loss in Lumbar Spinal Stenosis Surgery: A Double-Blind Randomized Controlled Trial

Abstract

Objective: To compare peri-operative surgical blood loss in laminectomy with spinal fusion surgery, using tranexamic acid (TXA) in one group, versus a control group given a placebo. Methods: A prospective double-blind randomized controlled trial studied lumbar spinal stenosis patients who underwent decompressive laminectomy with spinal fusion at Maharat Nakorn Ratchasima Hospital from 2009 to 2010. Results: Forty three patients were included in the study. The intra-operative and peri-operative blood loss was insignificantly reduced in the TXA group versus placebo group (mean: 493.2 ml. VS 526.2 ml. p=0.74) (mean: 932.9 ml. VS 1127.6 ml. p=0.19), respectively. However, post-operative blood loss was reduced significantly in the TXA group compared to placebo group (mean: 439.8 ml. VS 601.2 ml. p=0.04). However, there was no difference in blood transfusion requirements between the two groups. The number of decompressed levels and surgical duration were two factors related to perioperative blood loss. Conclusions: Intravenous tranexamic acid connot significantly reduce total peri-operative blood loss in laminectomy and spinal fusion surgery. It does however, significantly reduce post-operative blood loss. We found no difference in the number of blood transfusions required between the TXA and placebo groups