• Keskin Emrah, Aydin Hasan Ali, Ozgen Utku, Kalayci Murat, Simsek Kenan, and Baklaci Deniz.
• Department of Neurosurgery, Bulent Ecevit University Medical Faculty, Zonguldak, Turkey.
• J Coll Physicians Surg Pak. 2021 Dec 1; 31 (12): 1449-1454.

ObjectiveTo investigate the effectiveness of topical tranexamic acid (TXA) use on bleeding and drain withdrawal time in adult patients undergoing thoracolumbar fusion surgery.Study DesignCross-sectional comparative study.Place And Duration Of StudyZonguldak Bülent Ecevit University Hospital, Zonguldak, Turkey, from January 2019 to August 2020.Methodology The data of patients, who received thoracic and/or lumbar fusion surgery, were evaluated. The patients were divided into two groups as Group A (30 patients) in which 1 g topical TXA was applied to the surgical site at the end of the surgery; and Group B (30 patients) who did not receive this medication.ResultsThe body mass index (BMI) and the patients' demographic factors were similar in both the groups. There were no statistically significant differences between the two groups in terms of the surgical time and level, perioperative ES and FFP transfusion rates (p >0.05). While the amount of perioperative bleeding was almost the same (650 mL, p = 0.778), the amount of postoperative bleeding was lower in Group A (138.1 ± 55.6 mL) in comparison to Group B (230.3 ± 65.4 mL). Postoperative ES transfusion was performed on two patients in Group A (6.7%) and six patients in Group B (30%) (p = 0.02). Accordingly, the mean drain withdrawal time in Group A was 3 (2.8-3.0); days, and in Group B, this time was 6 (5.0-6.0) days (p <0.001). Systemic side effects, especially thromboembolism, were not observed in any of the patients.ConclusionThe topical use of TXA in spinal fusion surgery reduced perioperative blood loss. Key Words: Blood loss, Thoracolumbar spinal surgery, Tranexamic acid.

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