Tranexamic Acid Diminishes Intraoperative Blood Loss in Duchenne Muscular Dystrophy Scoliosis Spinal Fusions
Methods: All patients underwent posterior spinal fusion with the same technique using 2 rods and multiple sublaminar wires. Group 1: TXA was not used in 36 patients. The mean number of levels fused was 14.3. Group 2: TXA was used in 16 patients. TXA dose was 100mg/kg in solution over 15 minutes before incision followed by an infusion of 10 mg.kg-1.h-1 during surgery. The mean number of levels fused was 14.7. Standardized measurements of intraoperative blood loss were used. Assessment A compared total amount of blood loss in milliliters (ml) per patient and assessment B calculated blood loss as a percentage in relation to estimated blood volume [estimated blood loss (EBL)/estimated blood volume (EBV) X 100]. The EBV was calculated to be 70 ml/kg (body weight).
Results: A: Mean blood loss with TXA was 1976+/-860 ml (range 760-4000) and without TXA was 3382+/-1795 ml (range 600-9580) [highly significant difference (Student t=3.81, p<0 .001)]. Blood loss with TXA was decreased by 42% to only 58% of the blood in patients not treated TXA. B: Accounting for patient weight and estimated volume, mean % without 49+/-30% vs. 111+/-67% (Student t="4.63," p<0.001). This more physiologic indicator shows that 56% 44% No complications from therapy were observed.
Conclusion: Intraoperative TXA significantly reduces blood loss in DMD patients undergoing posterior spinal fusion spinal for scoliosis.