Analysis of the effect of local tranexamic acid application on the need for blood transfusion in patients with skoliosis undergoing spinal fusion surgery

TURAN T., ANALYSIS OF THE EFFECT OF LOCAL TRANEXAMIC ACID APPLICATION ON THE NEED FOR BLOOD TRANSFUSION IN PATIENTS WITH SKOLIOSIS UNDERGOING SPINAL FUSION SURGERY DEPARTMENT OF ORTHOPEDICS AND TRAUMATOLOGY, SPECIALIZATION THESIS, GAZIANTEP, 2025 Objective: Scoliosis is a deformity characterized by lateral curvature of the spine and may require spinal fusion surgery in severe cases. Since significant blood loss may occur during this surgery, antifibrinolytic agents are used to reduce the need for blood transfusion. The aim of this study is to retrospectively examine the effect of local tranexamic acid (TXA) administration on the need for blood transfusion in scoliosis patients undergoing spinal fusion surgery. Methods: A total of 51 scoliosis patients who underwent spinal fusion surgery at the Orthopedics and Traumatology Clinic of Gaziantep University Şahinbey Research and Application Hospital were included in the study. Patients were divided into two groups: those who received TXA (n=37) and those who did not (n=15). Results: The groups were similar in terms of age (14.21±3.75 vs. 13.86±3.81 years, p>0.05) and gender distribution (73% female vs. 80% female, p>0.05). There were no significant differences between the groups in terms of intraoperative blood loss, surgical duration (147.83±41.75 vs. 128.66±29.06 minutes, p>0.05), number of fusion levels, number of screws, and postoperative drain fluid volume (p>0.05). However, the number of free drains was significantly higher in the group without TXA (p<0.001). The need for postoperative blood transfusion was 21.6% in the group with TXA and 46.7% in the group without TXA, and the difference was not significant (p>0.05). In both groups, the postoperative Cobb angle decreased significantly (p<0.001), and hemoglobin values decreased (p<0.001); the difference between groups was not significant (p>0.05). In the Lenke classification, Lenke type 5C was significantly more common in the TXA group (p<0.05). Conclusion: In conclusion, although local TXA administration showed a tendency to reduce the need for postoperative blood transfusion, statistical significance was not achieved. These findings emphasize the need for prospective studies with larger samples. Keywords: Blood transfusion, Lenke classification, Scoliosis, Spinal fusion, Tranexamic acid