Tranexamic Acid Demonstrated a Trend Toward Decreased Perioperative Blood Loss in Posterior Decompression Surgery of Patient with Metastatic Spinal Tumor.

BACKGROUND

To explore the effect of tranexamic acid (TXA) on perioperative blood loss in posterior decompression surgery of patient with metastatic spinal tumor.

METHODS

Three hundred sixty-eight consecutive patients between May 2011 and Aug 2022 were retrospectively reviewed. One hundred eighty patients (182 surgeries) met the criteria and were included in the study. Sixty-two surgeries received preoperative intravenous TXA (TXA group), and 120 did not (non-TXA group). The primary outcome was total blood loss. T-test, Mann-Whitney U, and chi-square tests were used to evaluate the difference in baseline data, total blood loss, and other outcome measures between the two groups.

RESULTS

Patients with hyper vascular tumors had significantly more blood loss compared with non-hyper vascular tumors (2002(1531,2792) mL vs 1469(1036,1962) mL, p=0.001). There was no significant different in the postoperative venous thromboembolism of the lower limb between the two groups. For patients with non-hyper vascular tumors, the blood loss (1216(827, 1709) mL vs 1561(1146, 2019) mL, p = 0.012) and postoperative drainage (1-day post-operation: 240(150,290) mL vs 280(150,395) mL, p=0.040; 3-days post-operation: 450(348,630) mL vs 613(398,799) mL, p=0.025) of TXA group were significantly less compared with that of the non-TXA group. Meanwhile, the TXA group had significantly less postoperative hospitalization compared with the non-TXA group (11.0(9.0, 13.3) days vs 12.5(9.0, 16.3) days, p=0.023). For patients with hyper vascular tumors, there were no significant differences in the blood loss and amount of postoperative drainage between the two groups.

CONCLUSION

Preoperative intravenous TXA demonstrated a trend toward decreased perioperative blood loss in posterior decompression surgery of spinal metastases with non-hyper vascular tumors.