title: Use of tranexamic acid for controlling bleeding in thoracolumbar scoliosis surgery with posterior instrumentation.
abstract: OBJECTIVE
  Scoliosis surgery involves major blood loss and frequently requires blood transfusion. The cost and risks involved in using allogeneic blood have motivated investigation of methods capable of reducing patients' bleeding during operations. One of these methods is to use antifibrinolytic drugs, and tranexamic acid is among these. The aim of this study was to assess the use of this drug for controlling bleeding in surgery to treat idiopathic scoliosis.
  
  
  METHODS
  This was a retrospective study in which the medical files of 40 patients who underwent thoracolumbar arthrodesis by means of a posterior route were analyzed. Of these cases, 21 used tranexamic acid and were placed in the test group. The others were placed in the control group. The mean volumes of bleeding during and after the operation and the need for blood transfusion were compared between the two groups.
  
  
  RESULTS
  The group that used tranexamic acid had significantly less bleeding during the operation than the control group. There was no significant difference between the groups regarding postoperative bleeding and the need for blood transfusion.
  
  
  CONCLUSIONS
  Tranexamic acid was effective in reducing bleeding during the operation, as demonstrated in other studies. The correlation between its use and the reduction in the need for blood transfusion is multifactorial and could not be established in this study. We believe that tranexamic acid may be a useful resource and that it deserves greater attention in randomized double-blind prospective series, with proper control over variables that directly influence blood loss.
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Vinícius Magno
authors.initials: VM
authors.lastname: da Rocha
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Alderico Girão Campos
authors.initials: AG
authors.lastname: de Barros
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Cleiton Dias
authors.initials: CD
authors.lastname: Naves
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Nayara Lopes
authors.initials: NL
authors.lastname: Gomes
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Julie Calixto
authors.initials: JC
authors.lastname: Lobo
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Luís Cláudio
authors.initials: LC
authors.lastname: Villela Schettino
authors.affiliation: National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
authors.forename: Luís Eduardo Carelli Teixeira
authors.initials: LE
authors.lastname: da Silva
keywords: Blood transfusion; Duration of bleeding; Scoliosis/surgery; Tranexamic acid