ArticleSpine2025
Optimal Tranexamic Acid Dosing for Adolescent Idiopathic Scoliosis Surgery: A Frequentist Network Meta-Analysis.
Article in Spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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Who cites it
2 citing papers in PubMed.
- The Role of Intravenous Tranexamic Acid for Posterior Spinal Fusion in Pediatric Non-Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Safety in Spine Surgery: Risk Factors for Intraoperative Blood Loss and Management Strategies.Life (Basel, Switzerland) · 2025Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review and network meta-analysis (NMA).
objectiveThis NMA evaluates the clinical efficacy and safety of various doses of Tranexamic acid (TXA) for adolescent idiopathic scoliosis (AIS) instrumentation. SUMMARY OF BACKGROUND DATA: TXA is an antifibrinolytic agent widely used in spine surgery. However, the optimal TXA dose remains unclear, especially for younger patients.
methodsWe performed a systematic search across PubMed, Scopus, Web of Science, and the Cochrane Library up to March 2025. We included studies that compared different TXA doses or patients without TXA in AIS surgery. We evaluated five TXA doses: TXA 0 (control without TXA); TXA 1 (10 mg/kg bolus + 1 mg/kg/hr infusion); TXA 2 (15-20 mg/kg bolus + 1-10 mg/kg/hr infusion); TXA 3 (30-50 mg/kg bolus of TXA + 5-10 mg/kg/hr infusion); and TXA 4 (100 mg/kg bolus of TXA + 10 mg/kg/hr infusion). This meta-analysis compared bleeding volume, surgical time, transfusion rates, length of hospital stay, and complications. Random-effects frequentist NMA was employed. Treatments were ranked with P-scores.
resultsA total of 1,523 patients, mainly aged 13 to 18 years from 16 studies were included in this analysis (eight retrospective studies). TXA 4 outperformed other doses in reducing intraoperative bleeding, operation time, and cell saver volume. TXA 3 also showed significant benefits but was less effective than TXA 4. There was no difference in complication rates, although these data were not uniformly reported in the studies. No evidence of publication bias was found. Quality concerns were observed.
conclusionThe tranexamic acid dose of 100 mg/kg bolus + 10 mg/kg/hr infusion (TXA 4) was the most effective in bleeding control during AIS instrumentation in teenagers. While these results are promising, more randomized trials are needed to directly compare various TXA doses.
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Registered trials
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