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- Title
Combined Use of Tranexamic Acid and Rivaroxaban in Posterior/Transforaminal Lumbar Interbody Fusion Surgeries Safely Reduces Blood Loss and Incidence of Thrombosis: Evidence From a Prospective, Randomized, Double-Blind, Placebo-Controlled Study.
- Authors
Li, Xiang; Jiao, Guangjun; Li, Jingyi; Ji, Weibin; Hao, Zhiwei; Gong, Fangli; Chen, Yunzhen
- Abstract
Study Design: A prospective, randomized, double-blind, placebo-controlled study. Objectives: There are few studies examining the balance between preventing venous thrombus embolism (VTE) and reducing blood loss in posterior/transforaminal lumbar interbody fusion (PLIF/TLIF) surgeries. This study aimed to evaluate the efficacy and safety of the combine application of TXA and rivaroxaban in patients undergoing PLIF/TLIF and explore relevant factors related to blood loss and VTE. Methods: Patients in group A which was the control group received 0.9% NaCl solution intravenously. Group B was treated by an intravenous injection of 2 g tranexamic acid (TXA) and the local use of 1 g intraoperatively. Group C was treated the same as group B intraoperatively, and they received 10 mg rivaroxaban qd treatment postoperatively. Eligible patients with an Autar score ≤ 10 were randomly assigned to group A or group B. Patients with an Autar score >10 were allocated into group C. Results: The intraoperative blood loss and postoperative drainage were lower in groups B and C than in group A (P <.001). The blood transfusion rate in group B was lower than that in group A (P <.001), while the incidence of VTE in group C was lower (P <.001). Four factors were found to be positively correlated with obvious total blood loss (P <.05). The data showed that 5 factors were correlated with the development of a thrombus (P <.1). Conclusions: The combination of TXA and rivaroxaban in PLIF/TLIF patients is safe and effective in reducing D-dimer levels associated with VTE and reducing blood loss.
- Subjects
TRANEXAMIC acid; SPINAL fusion; SPINAL surgery; SURGICAL blood loss; RIVAROXABAN; THROMBOSIS; INTRAVENOUS injections
- Publication
Global Spine Journal, 2023, Vol 13, Issue 5, p1229
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/21925682211024556