Evidence map›Paper›PMID 39789531›Full record

SynthesisBMC surgery2025

Efficacy and safety of topical versus intravenous tranexamic acid in spinal surgery: a systematic review and meta-analysis.

Chengxin Xie, Liwei Zhang, Guoping Cai, Yongwei Su, Peng Wang, Hua Luo

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Comparative efficacy and safety of different tranexamic acid administration in spine surgery: a network meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chengxin Xie *Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China.
Liwei Zhang *Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China.
Guoping Cai *Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China.
Yongwei Su *Department of Orthopedic, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121000, China.
Peng WangDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China.
Hua LuoDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China. 18732196660@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe relative efficacies of topical and intravenous tranexamic acid (TXA) in spinal surgery remain controversial. This meta-analysis aimed to compare the efficacy and safety of topical versus intravenous TXA in spinal surgery, with a particular focus on the impacts on intraoperative blood loss (IBL) and associated outcomes.

methodsWe searched the PubMed, EMBASE, Medline, and Cochrane Library databases to identify all literature related to topical and intravenous TXA in spinal surgery. Six trials met the inclusion criteria. The IBL, postoperative drainage volume, total blood loss, postoperative hematological variables, postoperative blood transfusions, and complications were analyzed.

resultsThe meta-analysis of randomized controlled trials indicated that IBL and total blood loss were markedly higher in the group receiving topical TXA compared to the intravenous TXA group. Conversely, data from retrospective studies did not show significant differences between the two groups. Hemoglobin levels on postoperative days 1 and 3 were significantly lower in the topical TXA group than in the intravenous TXA group. No significant differences were observed between the topical and intravenous TXA groups regarding other postoperative hematological parameters, drainage volume, transfusion rates, and complications.

conclusionsThe current evidence suggests that topical TXA does not significantly reduce postoperative blood loss in spinal surgery compared with intravenous TXA, but has good safety and does not increase the associated risks. There is a need for high-quality studies that explore the effects of topical TXA in spinal surgery.

Indexed as

Administration, IntravenousAdministration, TopicalAntifibrinolytic AgentsBlood Loss, SurgicalTranexamic AcidHumansPostoperative HemorrhageRandomized Controlled Trials as TopicSpineTreatment OutcomeAntifibrinolytic AgentsTranexamic AcidBlood lossComplicationsHemoglobinSpinal surgeryTranexamic acid

Identifiers

PMID39789531
PMCPMC11714873

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.