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J Neurol Surg A Cent Eur Neurosurg 2024; 85(03): 280-287
DOI: 10.1055/s-0043-1769127
Original Article

The Efficacy and Safety of Topical Saline Irrigation with Tranexamic Acid on Perioperative Blood Loss in Patients Treated with Percutaneous Endoscopic Interlaminar Diskectomy: A Retrospective Study

Yu Zhang    *
1   Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
,
Wenjie Zhao   *
2   Graduate School of Dalian Medical University, Dalian, China
,
Man Hu
2   Graduate School of Dalian Medical University, Dalian, China
,
Xin Liu
1   Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
,
Qing Peng
1   Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
,
Bo Meng
2   Graduate School of Dalian Medical University, Dalian, China
,
Sheng Yang
2   Graduate School of Dalian Medical University, Dalian, China
,
Xinmin Feng
1   Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
,
Liang Zhang
1   Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
› Author Affiliations Funding This study is supported by the National Natural Science Foundation of China (82172462), Traditional Chinese Medicine Science and Technology Development Plan Project of Jiangsu Province (YB2020085), Key Projects of Social Development of Yangzhou City (YZ2021083).
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Abstract

Background Tranexamic acid (TXA) is safe and effective in preventing bleeding during spinal surgery. However, there is currently no relevant research on the efficacy and safety of adding TXA to the saline irrigation fluid in percutaneous endoscopic interlaminar diskectomy (PEID). This study aimed to evaluate the efficacy and safety of topical saline irrigation with TXA for PEID in the treatment of lumbar disk herniation.

Methods In this single-center, retrospective cohort study, patients who underwent PEID for L5–S1 lumbar disk herniation were included and allocated to two groups according to whether they had been administered TXA. PEID was performed with saline irrigation fluid containing 0.33 g of TXA per 1 L of saline in the TXA group (n = 38). In the control group (n = 51), the saline irrigation fluid was injected with the same volume of normal saline. All PEIDs were performed by the same spine surgery team. The hidden blood loss (HBL), intraoperative blood loss (IBL), total blood loss (TBL), amount of fluid used, operation time, visual clarity, hospital stay, blood transfusion rate, coagulation index, and complication rate were compared between the two groups.

Results The TBL, HBL, and IBL in the TXA group were significantly lower than those of the control group. The postoperative hemoglobin in the TXA group was significantly higher than that of the control group. Visual clarity was significantly better and the operation time was significantly shorter in the TXA group. However, there was no significant difference in postoperative hematocrit, blood coagulation function, amount of fluid used, blood transfusion rate, and perioperative complications between the two groups.

Conclusion In PEID, the addition of TXA to topical saline irrigating fluid can significantly reduce the HBL, IBL, and TBL. The addition of TXA to topical saline irrigating fluid can improve visual clarity in the surgery and reduce operation time, but it does not change the coagulation function or the complication rate.

Keywords

hidden blood loss - percutaneous endoscopic interlaminar diskectomy - tranexamic acid - topical - visual clarity

Ethics Approval and Consent to Participate

This study was conducted in agreement with the Declaration of Helsinki and its later amendments or comparable ethical standards and had been approved by the Ethics Committee of Clinical Medical College of Yangzhou University (approval numbers: 2021LY-126). Written informed consent was obtained from all participants in this study. All the methods were carried out in accordance with relevant guidelines and regulations.


Consent for Publication

Written informed consent was obtained from the patient for publication of this article and any accompanying images.


Availability of Data and Materials

All data generated or analyzed in this study are included in the article.


Author Contribution

Y.Z. and W.Z. were responsible for protocol/project development, methodology, validation, software, data curation, formal analysis, resources, and writing of the original draft. M.H. and X.F. were responsible for validation, software, data curation, and formal analysis. X.L., B.M., S.Y., and Q.P. were responsible for software, data curation, and formal analysis. L.Z. were responsible for conceptualization, protocol/project development, visualization, supervision, project administration, funding acquisition, and writing and review and editing of the manuscript. All the authors read and approved the final manuscript for publication.


* These authors contributed equally to this work and share the first authorship.




Publication History

Received: 25 September 2022

Accepted: 07 March 2023

Article published online:
16 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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