Using tranexamic acid soaked absorbable gelatin sponge following complex posterior lumbar spine surgery: A randomized control trial

•A prospective randomized control trail for the use of TXA-soaked Gelfoam in spine surgery was reported.•TXA-soaked Gelfoam could more effectively reduce post-operative blood loss and blood transfusions.•TXA-soaked Gelfoam could lead to significant cost savings.

ObjectivesThis paper aims to determine whether the use of Tranexemic Acid (TXA) - soaked absorbable gelatin sponge could more effectively reduce post-operative blood loss and blood transfusion requirements among low-risk adult patients undergoing lumbar spine surgery.MethodsA total of 90 consecutive patients undergoing surgery for multilevel posterior lumbar degenerative procedures were prospectively randomized into one of three groups: - TXA Soaked Gelfoam group, absorbable gelatin sponge group or control group. Demographic distribution, total drain output, blood transfusion requirement, length of hospital stay, the number of readmissions, and postoperative complications were analyzed.ResultsIn the TXA Soaked Gelfoam, Gelfoam, and control groups, the respective hemovac drainage at the first 8 h postoperatively was 81.06 ± 61.21, 166.73 ± 76.76, and 155.67 ± 92.94 ml respectively. The second 8 h period drainage for the same groups postoperatively was 46.67 ± 40.09, 55.10 ± 43.43, and 82.50 ± 56.67 ml and 23.73 ± 25.56, 32.43 ± 25.81 and 44.20 ± 32.44 ml for the third 8 h period postoperatively. The duration of the post-operative drain left in the TXA Soaked Gelfoam group was significantly shorter than the Gelfoam and control groups (p = 0.019 and 0.000, respectively). The TXA Soaked Gelfoam and Gelfoam also had a significantly shorter hospital stay than the control group (p = 0.014, and 0.036, respectively). No patient developed adverse reactions attributable to the tranexamic acid soaked absorbable gelatin sponge.ConclusionsTXA-soaked absorbable gelatin sponge is a safe, effective treatment for reduction of post-operative blood loss and blood transfusions among low-risk adult patients undergoing lumbar spine surgery.