Safety of tranexamic acid in surgically treated isolated spine trauma

ARTICLE HIGHLIGHTS

Research background

There is no data looking at safety of the tranexamic acid (TXA) in the surgical management of isolated whole spine trauma. This study sets the foundation for the future research work.

Research motivation

This is the only study looking at the safety of TXA in surgically treated isolated whole spine trauma. There is no consensus on the administration, dosage and route of TXA delivered for these injuries.

Research objectives

The overall objective of this study is to look at the safety of the TXA in surgically treated isolated whole spine trauma.

Research methods

This prospective observational study included patients aged ≥ 17 years with isolated spine trauma requiring surgical intervention over a 6-month period at two major trauma centers in the United Kingdom. We used SPSS for statistical analysis.

Research results

We identified 67 patients: 26 (39%) and 41 (61%) received and did not receive TXA, respectively. Both groups were matched in terms of age, gender, American Society of Anesthesiologists grade, and mechanism of injury. A higher proportion of patients who received TXA had a subaxial cervical spine injury classification or thoracolumbar injury classification score > 4 (74% vs 56%). All patients in the TXA group underwent an open approach with a mean of 5 spinal levels involved and an average operative time of 203 min, compared with 24 patients (58%) in the non-TXA group who underwent an open approach with an average of 3 spinal levels involved and a mean operative time of 159 min. Among patients who received TXA, blood loss was < 150 and 150–300 mL in 8 (31%) and 15 (58%) patients, respectively. There were no cases of thromboembolic events in any patient who received TXA.

Research conclusions

We concluded that TXA is safe for isolated spine trauma. It is challenging to determine whether TXA effectively reduces blood loss because most surgeons prefer TXA for open or multilevel cases.

Research perspectives

This study sets the foundation for further research trials in patients with isolated spine trauma managed with surgical intervention.