SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Comparative efficacy and safety of different tranexamic acid administration in spine surgery: a network meta-analysis.
Synthesis in 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. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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Abstract
backgroundTranexamic acid (TXA) is widely used to reduce blood loss in spine surgery. Different administration routes, including intravenous (IV), topical, and oral, have been studied, but a comprehensive comparison of their efficacy and safety remains lacking. This network meta-analysis aims to compare the effectiveness and safety of various TXA administration methods in spine surgery, focusing on blood loss, transfusion rates and other perioperative parameters.
methodsWe systematically reviewed randomized controlled trials (RCTs) published until January 2025, comparing different TXA regimens in spine surgery. Data on blood loss, transfusion rates, postoperative complications, post-drainage, length of hospital stay and operative time are extracted. A network meta-analysis is conducted using a Bayesian random effects model to rank the efficacy and safety of TXA routes.
resultsA total of 12 RCTs involving 1980 patients are included. Topical TXA + IV TXA demonstrated the highest efficacy in reducing intraoperative blood loss, post-operative blood loss, overall blood loss, Hct, Hgb, transfusion rates, post-drainage, operative time and hospital stay, with the highest probability of being the best treatment. Oral TXA showed fewer complications, making it a safer option for low-risk patients. Subgroup analysis confirmed the superiority of topical TXA + IV TXA in spine fusion surgeries, particularly for overall blood loss control and reducing transfusion requirements.
conclusionFor open thoracolumbar fusion surgery, Topical TXA + IV TXA is the most effective regimen for reducing blood loss and enhancing recovery in high-risk surgeries. Oral TXA offers a safer alternative for low-risk patients. Extrapolating these findings to other spine procedures still requires further randomized controlled trials. Tailoring TXA administration to individual patient needs optimizes outcomes and reduces complications.
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Registered trials
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.