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Does the use of tranexamic acid intraoperatively reduce postoperative blood loss and complications following biportal endoscopic lumbosacral decompression? – Lumbar Spinal Stenosis

The article evaluates the impact of intraoperative tranexamic acid (TXA) use on postoperative blood loss in biportal endoscopic decompression surgery for common lumbar pathologies. The study included 84 patients undergoing biportal endoscopic lumbar discectomies and decompressions, with one cohort receiving TXA and the other not. Results showed that post-operative drain output was significantly lower in the TXA cohort, with no differences in estimated blood loss or post-operative complications. Patient-reported outcomes improved similarly in both groups. The study suggests that systemic intraoperative TXA administration can decrease post-operative blood loss without affecting patient outcomes, and larger, randomized studies are needed to assess the cost-effectiveness of TXA use in biportal spinal endoscopy

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spine centre in UK

Published article

CONCLUSIONS: Systemic intraoperative TXA administration is associated with a significant decrease in post-operative blood loss in biportal spinal endoscopy, with no impact on the improvement in patient-reported outcomes (PROs) or rate of post-operative complications. Single level biportal discectomies had significantly less postoperative drainage with TXA and may not need drains postoperatively. Larger, randomized studies are necessary to evaluate the cost-effectiveness of TXA use in biportal…

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Spine Surg. 2024 Mar 20;10(1):68-79. doi: 10.21037/jss-23-129. Epub 2024 Mar 14. ABSTRACT BACKGROUND: Biportal endoscopic spine surgery is an effective minimally invasive technique for treating common lumbar pathologies. We aim to evaluate the impact of intraoperative tranexamic acid (TXA) use on postoperative blood loss in biportal endoscopic decompression surgery. METHODS: Patients undergoing biportal endoscopic,

J Spine Surg. 2024 Mar 20;10(1):68-79. doi: 10.21037/jss-23-129. Epub 2024 Mar 14.

ABSTRACT

BACKGROUND: Biportal endoscopic spine surgery is an effective minimally invasive technique for treating common lumbar pathologies. We aim to evaluate the impact of intraoperative tranexamic acid (TXA) use on postoperative blood loss in biportal endoscopic decompression surgery.

METHODS: Patients undergoing biportal endoscopic lumbar discectomies and decompressions either by same day surgery or overnight stay at a single institution beginning in October 2021 were prospectively enrolled. This study was non-randomized, non-blinded with the first cohort of consecutive patients receiving 1 g of intravenous TXA intra-operatively before closure and the second cohort of consecutive patients receiving no TXA. Exclusion criteria included any revision surgery, any surgery for the diagnosis of spinal instability, infection, tumor, or trauma, any contraindication for TXA.

RESULTS: Eighty-four patients were included in the study, with 45 (54%) receiving TXA and 39 (46%) not receiving TXA. Median follow-up was 168 days [interquartile range (IQR), 85-368 days]. There were no differences in patient or surgical characteristics between cohorts. Estimated blood loss (EBL) was similar (P=0.20), while post-operative drain output was significantly lower in the TXA cohort (P=0.0028). Single level discectomies had significantly less drain output as compared to 2 level unilateral laminotomy, bilateral decompression (ULBD) cases (P<0.005). Post-operative complications were similar, with low rates of wound complication (1.2%) and transient postoperative weakness (2.4%, P>0.99 for both). Oswestry disability index (ODI), visual analog scale (VAS) back and VAS leg scores decreased significantly; the absolute decrease in scores did not differ between groups (P=0.71, 0.22, 0.86, respectively).

CONCLUSIONS: Systemic intraoperative TXA administration is associated with a significant decrease in post-operative blood loss in biportal spinal endoscopy, with no impact on the improvement in patient-reported outcomes (PROs) or rate of post-operative complications. Single level biportal discectomies had significantly less postoperative drainage with TXA and may not need drains postoperatively. Larger, randomized studies are necessary to evaluate the cost-effectiveness of TXA use in biportal spinal endoscopy.

PMID:38567010 | PMC:PMC10982914 | DOI:10.21037/jss-23-129

The London Spine Unit : top spine centre in UK

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Does the use of tranexamic acid intraoperatively reduce postoperative blood loss and complications following biportal endoscopic lumbosacral decompression?

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J Spine Surg. 2024 Mar 20;10(1):68-79. doi: 10.21037/jss-23-129. Epub 2024 Mar 14. ABSTRACT BACKGROUND: Biportal endoscopic spine surgery is an effective minimally invasive technique for treating common lumbar pathologies. We aim to evaluate the impact of intraoperative tranexamic acid (TXA) use on postoperative blood loss in biportal endoscopic decompression surgery. METHODS: Patients undergoing biportal endoscopic

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