title: Effectiveness of tranexamic acid in reducing blood loss in spinal surgery: a meta-analysis.
abstract: BACKGROUND
  The aim of present meta-analysis was to evaluate the effectiveness of tranexamic acid (TXA) use in reducing blood loss and the related thrombotic complications in spinal surgery.
  
  
  METHODS
  Three databases (MEDLINE, EMBASE, and the Cochrane Library) were searched through October 2012 to identify the relevant randomized controlled trials (RCTs) regarding the TXA effective in spinal surgery. Mean differences (MDs) of blood loss, blood transfusions, and postoperative partial thromboplastic time (PTT), odds ratios (ORs) of blood transfusion and thrombotic complication in TXA-treated group compared to placebo group were extracted and combined using random-effect meta-analysis.
  
  
  RESULTS
  A total of 6 RCTs comprising 411 patients were included in the meta-analysis according to the pre-defined selection criteria. TXA-treated group had significantly less amount of blood loss and blood transfusions per patient, and had smaller proportion of patients who required a blood transfusion compared with the placebo group. The use of TXA can significantly reduce the postoperative PTT with weighted MD of -1.59 [(95% confidence interval (CI):-3.07, -0.10] There is a null association between thrombosis complications and the use of TXA.
  
  
  CONCLUSIONS
  We conclude that the use of TXA in patients undergoing spinal surgery appears to be effective in reducing the amount of blood loss, the volume of blood transfusion, the transfusion rate, and the postoperative PTT. However, data were too limited for any conclusions regarding safety. More high-quality RCTs are required before recommending the administered of TXA in spinal surgery.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Feng-Ning
authors.initials: FN
authors.lastname: Li
authors.forename: Xuan
authors.initials: X
authors.lastname: Huang
authors.forename: Quan
authors.initials: Q
authors.lastname: Li
authors.forename: Zhi
authors.initials: Z
authors.lastname: Chen
authors.forename: Yi-Bo
authors.initials: YB
authors.lastname: Tang
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, No, 168 Changhai Road, Yangpu District, Shanghai 200433, China. shenhxgk@126.com.
authors.forename: Hong-Xing
authors.initials: HX
authors.lastname: Shen
authors.forename: Qing-Xin
authors.initials: QX
authors.lastname: Song
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid