Affordable Excellence: A Meta-Analysis on the Efficacy of Topical Tranexamic Acid in Reducing Blood Loss in Thoracolumbar Spinal Surgery.

Turkish neurosurgery Pub Date : 2026-01-01 DOI:10.5137/1019-5149.JTN.48875-25.2

Jyun-Yuan Huang, Tzu-Ning Chen, Hao-Kuang Wang, Kang Lu, Jui-Sheng Chen, Tsung-Jen Hsieh, Yu-Ying Wu, Min-Jung Lee, Po-Yuan Chen

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Abstract

Aim: To evaluate the efficacy and safety of topical tranexamic acid (tTXA) in thoracolumbar fusion surgery.

Material and methods: A systematic review was conducted per PRISMA guidelines. Studies from January 1970 to August 2024 were retrieved from PubMed, Cochrane, EMBASE, Medline, and Google Scholar. Randomized controlled trials, non-RCTs, and cohort studies comparing tTXA with placebo or standard care in thoracolumbar surgery were included.

Results: Eleven studies with 986 patients met the criteria. tTXA significantly reduced intraoperative blood loss (MD: -25.85 mL, p = 0.002), postoperative drain output (MD: -84.82 mL, p < 0.00001), transfusion rates (OR: 0.33, p = 0.0004), and hospital stay (MD: -0.67 days, p < 0.00001). It also increased postoperative hemoglobin (MD: 0.39 g/dL, p < 0.00001) but slightly prolonged operative time (MD: 3.73 minutes, p < 0.00001). No significant difference was found in complication rates (p = 0.36).

Conclusion: tTXA is effective in reducing blood loss and transfusion needs in thoracolumbar surgery, with minimal risk. Slightly increased operative time is clinically acceptable.

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负担得起的卓越：局部氨甲环酸减少胸腰椎手术出血量疗效的荟萃分析。

目的：在胸腰椎手术中，术中失血的处理仍然是一个挑战。局部氨甲环酸（tTXA）已成为一种具有成本效益的替代方案，提供局部抗纤溶作用，而没有静脉给药的全身风险。本荟萃分析评估了tTXA在胸腰椎融合手术中的疗效和安全性。材料和方法：根据PRISMA指南进行系统评价。1970年1月至2024年8月的研究检索自PubMed、Cochrane、EMBASE、Medline和谷歌Scholar。随机对照试验、非随机对照试验和队列研究比较了tTXA与安慰剂或标准治疗在胸腰椎手术中的应用。结果：11项研究986例患者符合标准。tTXA显著降低术中出血量（MD: -25.85 mL, p = 0.002）、术后排液量（MD: -84.82 mL, p 0.00001）、输血率（OR: 0.33, p = 0.0004）和住院时间（MD: -0.67天，p 0.00001）。术后血红蛋白升高（MD: 0.39 g/dL, p 0.00001），手术时间延长（MD: 3.73 min, p 0.00001）。并发症发生率差异无统计学意义（p = 0.36）。结论：tTXA能有效减少胸腰椎手术的失血量和输血需求，且风险最小。稍微延长手术时间在临床上是可以接受的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Turkish neurosurgery

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