title: Does Tranexamic Acid Reduce Perioperative Bleeding in Short Segment Pedicle Screw Fixation in Thoracolumbar Spine Fractures?
abstract: BACKGROUND
  Blood loss with spinal surgery is common potential cause of morbidity and often requires blood transfusion. Tranexamic acid (TXA), is effective in reducing bleeding in patients undergoing knee arthroplasty. TXA used in spine surgery studies have included different cases leading to inconsistence of surgical procedures. Purpose of this prospective observational study was to examine effect of TXA decreasing bleeding in short segment pedicle screw fixation for thoracolumbar fractures.
  
  
  METHODS
  38 patients' undergoing short segment pedicle screw for thoracolumbar fractures were enrolled in study from July 2011 to August 2013. There were 28 male and 10 female patients, with an average age of 36.5 years. Patients received 10 mg/kg of TXA or a control 30 minutes intravenously before skin incision and 3 hours post-operative and oral medication for three days. Intraoperative bleeding was estimated by weighing surgical sponges, blood collected by suction container and by subtracting all irrigation fluid. Postoperative bleeding was measured from volume in vacuum drainage bag.
  
  
  RESULTS
  Twenty (20) patients were in control group and eighteen(18) to TXA group. There were no statistical differences between groups in terms of age, gender, co-morbidities, and operating time, preoperative Hemoglobin, PT and INR. Intra-operative bleeding in TXA group was significant than in control group. Post-operative drainage and Hemoglobin in first 48 h was reduced compared with placebo in TXA group. Need for post-operative transfusion was nil in TXA group.
  
  
  CONCLUSIONS
  Administration of TXA before surgery significantly reduces perioperative bleeding in patients undergoing short segment pedicle screw fixation for thoracolumbar spine fractures.
authors.affiliation: Department of Orthopaedic Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
authors.forename: R L
authors.initials: RL
authors.lastname: Pradhan
authors.affiliation: Department of Orthopaedic Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
authors.forename: B K
authors.initials: BK
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D014148:Tranexamic Acid / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: bleeding; spinal surgery; tranexamic acid.