Effect of the administration route on the hemostatic efficacy of tranexamic acid in patients undergoing short-segment posterior lumbar interbody fusion: a systematic review and meta-analysis

氨甲环酸 医学 荟萃分析 止血剂 腰椎 外科 麻醉 止血 失血 内科学
作者
Matthew J. Hatter,Zach Pennington,Timothy I. Hsu,Tara Shooshani,Olivia Yale,Omead Pooladzandi,Sean S. Solomon,Bryce Picton,Marlena Ramanis,Nolan J. Brown,Sohaib Z. Hashmi,Yu-Po Lee,Nitin Bhatia,Martin H. Pham
出处
期刊:Journal of neurosurgery [Journal of Neurosurgery Publishing Group]
卷期号:: 1-12
标识
DOI:10.3171/2024.2.spine23779
摘要

OBJECTIVE Tranexamic acid (TXA) is an FDA-approved antifibrinolytic that is seeing increased popularity in spine surgery owing to its ability to reduce intraoperative blood loss (IOBL) and allogeneic transfusion requirements. The present study aimed to summarize the current literature on these formulations in the context of short-segment instrumented lumbar fusion including ≥ 1-level posterior lumbar interbody fusion (PLIF). METHODS The PubMed, Cochrane, and Web of Science databases were queried for all full-text English studies evaluating the use of topical TXA (tTXA), systemic TXA (sTXA), or combined tTXA+sTXA in patients undergoing PLIF. The primary endpoints of interest were operative time, IOBL, and total blood loss (TBL); secondary endpoints included venous thromboembolic complication occurrence, and allogeneic and autologous transfusion requirements. Outcomes were compared using random effects. Comparisons were made between the following treatment groups: sTXA, tTXA, and sTXA+tTXA. Given that sTXA is arguably the standard of care in the literature (i.e., the most common route of administration that to this point has been studied the most), the authors compared sTXA versus tTXA and sTXA versus sTXA+tTXA. Study heterogeneity was assessed with the I 2 test, and grouped analysis using the Hedge’s g test was performed for measurement of effect size. RESULTS Forty-five articles were identified, of which 17 met the criteria for inclusion with an aggregate of 1008 patients. TXA regimens included sTXA only, tTXA only, and various combinations of sTXA and tTXA. There were no significant differences in operative time, TBL, or postoperative drainage between the sTXA and tTXA groups or between the sTXA and sTXA+tTXA groups. CONCLUSIONS The present meta-analysis suggested clinical equipoise between isolated sTXA, isolated tTXA, and combinatorial tTXA+sTXA formulations as hemostatic adjuvants/neoadjuvants in short-segment fusion including ≥ 1-level PLIF. Given the theoretically lower venous thromboembolism risk associated with tTXA, additional investigations using large cohorts comparing these two formulations within the posterior fusion population are merited. Although TXA has been shown to be effective, there are insufficient data to support topical or systemic administration as superior within the open PLIF population.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
两个我发布了新的文献求助10
刚刚
花花完成签到,获得积分10
刚刚
刚刚
怕黑衣完成签到,获得积分10
1秒前
图灵桑发布了新的文献求助10
1秒前
LPeaQ应助桀桀桀采纳,获得10
2秒前
称心的麦片完成签到,获得积分10
2秒前
桐桐完成签到,获得积分0
3秒前
慕青应助finkle采纳,获得10
3秒前
SUN完成签到,获得积分10
4秒前
4秒前
4秒前
4秒前
4秒前
5秒前
6秒前
量子星尘发布了新的文献求助10
6秒前
李李完成签到 ,获得积分10
7秒前
蒲公英发布了新的文献求助20
8秒前
8秒前
LUCCAS发布了新的文献求助20
9秒前
9秒前
三叔完成签到,获得积分0
9秒前
9秒前
Alicia发布了新的文献求助10
10秒前
ossantu发布了新的文献求助10
10秒前
finkle完成签到,获得积分10
11秒前
ZJH发布了新的文献求助10
11秒前
youxiu1112发布了新的文献求助10
11秒前
wwxd完成签到,获得积分10
12秒前
Ryan完成签到,获得积分20
12秒前
Jayce完成签到,获得积分10
13秒前
14秒前
14秒前
14秒前
14秒前
Kuseite完成签到,获得积分10
14秒前
迅速冰岚发布了新的文献求助10
14秒前
LPeaQ应助期待采纳,获得10
14秒前
nan完成签到,获得积分20
15秒前
高分求助中
The Mother of All Tableaux Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 2400
Ophthalmic Equipment Market by Devices(surgical: vitreorentinal,IOLs,OVDs,contact lens,RGP lens,backflush,diagnostic&monitoring:OCT,actorefractor,keratometer,tonometer,ophthalmoscpe,OVD), End User,Buying Criteria-Global Forecast to2029 2000
Optimal Transport: A Comprehensive Introduction to Modeling, Analysis, Simulation, Applications 800
Official Methods of Analysis of AOAC INTERNATIONAL 600
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 588
T/CIET 1202-2025 可吸收再生氧化纤维素止血材料 500
Interpretation of Mass Spectra, Fourth Edition 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3951758
求助须知:如何正确求助?哪些是违规求助? 3497124
关于积分的说明 11086059
捐赠科研通 3227597
什么是DOI,文献DOI怎么找? 1784497
邀请新用户注册赠送积分活动 868586
科研通“疑难数据库(出版商)”最低求助积分说明 801154