Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Aug 31;20(1):390.
doi: 10.1186/s12891-019-2762-2.

Efficacy and safety of tranexamic acid usage in patients undergoing posterior lumbar fusion: a meta-analysis

Jianzhong Bai  1   2 , Pei Zhang  1 , Yuan Liang  1 , Jingcheng Wang  3 , Yongxiang Wang  4
Affiliations
Meta-Analysis

Efficacy and safety of tranexamic acid usage in patients undergoing posterior lumbar fusion: a meta-analysis

Jianzhong Bai et al. BMC Musculoskelet Disord. .

Abstract

Background: The purpose of this meta-analysis is to evaluate the efficacy and safety of tranexamic acid (TXA) for patients with degenerative lumbar disc herniation, stenosis or instability undergoing posterior lumbar fusion (PLF) surgery.

Methods: We searched PubMed, Embase, and Cochrane Library until May 1, 2018. Two reviewers selected studies, assessed quality, extracted data, and evaluated the risk of bias independently. Weighted mean difference (WMD) and relative risk (RR) were calculated as the summary statistics for continuous data and dichotomous data, respectively. We chose fixed-effects or random-effects models based on I2 statistics. RevMan 5.0 and STATA 14.0 software were used for data analysis.

Results: Nine studies enrolling 713 patients for the study. The pooled outcomes demonstrated that TXA can decrease total blood loss (TBL) in patients underwent PLF surgery [WMD = -250.68, 95% CI (- 325.06, - 176.29), P<0.001], intraoperative blood loss (IBL) [WMD = -72.57, 95% CI (- 103.94, - 41.20), P<0.001], postoperative blood loss (PBL) [WMD = -127.57, 95% CI (- 149.39, - 105.75), P<0.001], and the loss of hemoglobin (Hb) in postoperative 24 h [WMD = -0.31, 95% CI (- 0.44, - 0.18), P<0.001]. However, there is no significant difference between two groups in transfusion rate [RR =0.34, 95% CI (0.09, 1.28), P = 0.11], and none thrombotic event was happened in the two groups.

Conclusion: Our meta-analysis demonstrated that TXA can decrease the Hb loss, TBL, IBL, PBL, and without increasing the risk of thrombotic event in patients with degenerative lumbar disc herniation, stenosis or instability underwent PLF surgery. However, there was no significant difference in blood transfusion rates between the two groups.

Keywords: Blood loss; Lumbar degenerative disease; Posterior lumbar fusion; Spinal surgery; Tranexamic acid.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flow chart of studies selecting
Fig. 2
Fig. 2
The forest plot for total blood loss
Fig. 3
Fig. 3
The forest plot for intraoperative blood loss
Fig. 4
Fig. 4
The forest plot for postoperative blood loss
Fig. 5
Fig. 5
The forest plot for postoperative 24-h Hb decline value
Fig. 6
Fig. 6
The forest plot for transfusion rate
Fig. 7
Fig. 7
a The funnel plot for intraoperative blood loss. b The funnel plot for postoperative blood loss
See this image and copyright information in PMC

References

    1. Allain JP, Stramer SL, Carneiro-Proietti AB, Martins ML. Lopes da Silva SN, Ribeiro M, Proietti FA, Reesink HW. Transfusion-transmitted infectious diseases. Biologicals. 2009;37(2):71–77. - PubMed
    1. Vamvakas EC, Blajchman MA. Transfusion-relevanted mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood. 2009;113(15):3406–3417. - PubMed
    1. Hu SS. Blood loss in adult spinal surgery. Eur Spine J. 2004;13(Suppl 1):S3–S5. - PMC - PubMed
    1. Hardy JF, Desroches J. Natural and synthetic antifibrinolytics in cardiac surgery. Can J Anaesth. 1992;39(4):353–365. - PubMed
    1. Eubanks JD. Antifibrinolytics in major orthopaedic surgery. J Am Acad Orthop Surg. 2010;18(3):132–138. - PubMed

Publication types

MeSH terms

LinkOut - more resources