ReviewNorth American Spine Society journal2021
Tranexamic acid dosing strategies and blood loss reduction in multilevel spine surgery: A systematic review and network meta-analysis: Tranexamic acid for multilevel spine surgery.
Review in North American Spine Society journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Effect of tranexamic acid in spine surgeries: a systematic review and network meta-analysis.Frontiers in surgery · 2025Pooled it
- Efficacy and safety of tranexamic acid in cervical spine surgery: a systematic review and meta-analysis.Frontiers in neurology · 2024Pooled it
- Evaluation of the use of tranexamic acid in the postoperative period in patients with scoliosis undergoing posterior fusion.Neurosurgical review · 2024Trial
- Intraoperative use of tranexamic acid to reduce blood loss during cytoreductive surgery for advanced ovarian cancer: A randomized controlled clinical trial.Acta obstetricia et gynecologica Scandinavica · 2023Trial
- ERAS Protocol Elements and Neurosurgery-Specific Considerations: A Narrative Review.Turkish journal of anaesthesiology and reanimation · 2026Article
- International survey on the use of tranexamic acid in plastic surgery-Current practices and perspectives.JPRAS open · 2026Article
- Addressing kyphoscoliosis in Gaucher's disease: a multidisciplinary approach to a rare case.BMC musculoskeletal disorders · 2026Article
- Pediatric Anesthetic Management of a Patient With Warburg Micro Syndrome, a Rare Autosomal Recessive Genetic Disorder.Clinical case reports · 2025Article
- The effect of tranexamic acid on blood coagulation in primary total hip arthroplasty using rotational thromboelastometry: a randomized controlled trial.EClinicalMedicine · 2025Article
- An Overview of Adult Acute Traumatic Neurologic Injury for the Anesthesiologist:Current anesthesiology reports · 2025Article
- Clinical Effects of Intraoperative Use of Tranexamic Acid in Minimally Invasive Scoliosis Surgery for Adolescent Idiopathic Scoliosis.Clinics in orthopedic surgery · 2024Article
- Systemic vs. in-irrigation tranexamic acid in percutaneous nephrolithotomy A systematic review, Bayesian network meta-analysis, and meta-regression.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Review
- Improving visualization in shoulder arthroscopy.Clinics in shoulder and elbow · 2023Article
- Treatment of patients with metastatic epidural spinal cord compression using an enhanced recovery after surgery program.Frontiers in cell and developmental biology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor adults undergoing complex, multilevel spinal surgery, tranexamic acid (TXA) is an antifibrinolytic agent used to reduce blood loss. The optimal dosing of intravenous TXA remains unclear. This systematic review and meta-analysis compare various dosing regimens of intravenous TXA used in patients undergoing multilevel spine surgery (≥2 levels).
methodsPubMed, Cochrane, and EMBASE databases were searched for English language studies published January 2001 through May 2021 reporting use of TXA versus placebo for multilevel spine surgery. Primary outcomes of interest were intraoperative blood loss volume (BLV) and total BLV. A separate random effects model was fit for each outcome measure. Effect sizes were calculated as pooled mean differences (Diff) with corresponding 95% confidence intervals (CIs). Random effects network meta-analyses assessed whether the specific TXA dosing regimen influenced BLV.
resultsSeven studies with 441 patients were included for meta-analysis. Four different TXA dosing regimens were found: 1) 10 mg/kg + 1 mg/kg/h, 2) 10 mg/kg + 2 mg/kg/h, 3) 15 mg/kg, 4) 15 mg/kg + 1 mg/kg/h. Compared to placebo, patients treated with TXA had reduced intraoperative BLV (Diff = -185.0 ml; 95% CI: -302.1, -67.9) and reduced total BLV (Diff = -439.0 ml; 95% CI: -838.5, -39.6). No significant differences in intraoperative BLV among any of the TXA treatment groups was found. Patients given a TXA dose of 15 mg/kg + 1 mg/kg/h had significantly reduced total BLV in comparison to both placebo (Diff = -823.1 ml; 95% CI: -1249.8, -396.4) and a dose of 15 mg/kg (Diff = -581.2; 95% CI: -1106.8, -55.7).
conclusionsThis study found that intravenous TXA is associated with reduced intraoperative and total BLV, but it remains unclear whether there is an optimal TXA dose. Additional trials directly comparing different TXA regimens and administration routes are needed.
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