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162002

EFFECT OF TOPICAL USE OF TRANEXAMIC ACID IN PATIENTS WITH THORACOLUMBAR FRACTURE UNDERGOING POSTERIOR SPINAL FIXATION AND FUSION

Article

Last updated: 23 Jan 2023

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Abstract

Thoracic and lumbar spine trauma (TLST) is frequently associated with chest and abdominal injuries. Multilevel spinal fusions require a longer operative time, with significant soft tissue stripping as well as blood loss, which frequently leads to allogenic blood transfusion. Topical TXA might enhance patient safety, reducing excessive postoperative bleeding. To evaluate effect of topically applied 1 g TXA on postoperative whole blood transfusion and blood loss in neurologically intact patients with thoracolumbar spine fracture. A clinical prospective randomized study is done on 30 patients with thoracolumbar fracture, undergoing primary posterior instrumented fixation and fusion. Patients were randomized to 2 groups, first group (15 patients) was injected with saline only and second group (15 patients) was injected with mixture of tranexamic acid and saline. Patients were operated under general anesthesia, using a standard midline incision. Wounds are closed in layers over a 16 gauge suction drain; injection cocktail was delivered retrograde into the drain which was then closed for 2 hours. There was a highly significant decrease in blood loss in Group 2. The decrease in Hb level is less in the 2nd group than in the 1st group, indicating less postoperative anemia in the blood count (highly significant). Use of topically administered 1 g of TXA (20 mL) in thoracic and lumbar spinal trauma cases undergoing posterior instrumented fixation and fusion effectively decreased postoperative transfusion requirements. Treatment also reduced total drainage volume, time until drain removal, and length of postoperative hospital stay.

DOI

10.21608/ejor.2020.162002

Keywords

Tranexamic acid, Thoracolumbar fracture, Posterior spinal fixation and fusion

Authors

First Name

Mohamed

Last Name

Abdel Wanis

MiddleName

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Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag University, Sohag, Egypt

Email

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Orcid

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First Name

Ahmed

Last Name

Sleem

MiddleName

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Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag University, Sohag, Egypt

Email

assleem75@gmail.com

City

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Orcid

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First Name

Mostafa

Last Name

Abdel-all

MiddleName

-

Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag University, Sohag, Egypt

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City

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Orcid

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Volume

1

Article Issue

2

Related Issue

23717

Issue Date

2020-11-01

Receive Date

2020-08-09

Publish Date

2020-11-01

Page Start

75

Page End

82

Print ISSN

2682-4744

Online ISSN

2314-6710

Link

https://ejor.journals.ekb.eg/article_162002.html

Detail API

https://ejor.journals.ekb.eg/service?article_code=162002

Order

5

Type

Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations

Type Code

1,828

Publication Type

Journal

Publication Title

Egyptian Journal of Orthopedic Research

Publication Link

https://ejor.journals.ekb.eg/

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Article

Created At

23 Jan 2023