Comparison of Intravenous versus Topical Tranexamic Acid in Nondeformity Spine Surgery: A Meta-Analysis

Table 1

Characteristics of all the trials included in the meta-analysis.

Study

Country

Study type

Hemostatic agent

Surgical methods

Disease diagnosis

Anesthesia methods

Group

Age (years)

Gender M : F

BMI (kg/m^2)

TXA dosing (loading + maintenance)

Transfusion criteria

Wang et al, [8]

China

RCT

TXA

Percutaneous pedicle screw fixation

Thoracolumbar; fracture

General; anesthesia

Intravenous; topical

45.43 ± 8.18^†; 45.72 ± 9.96^‡

61 (34/27)^† 61; (37/24)^‡

21.26 ± 2.26^†; 21.37 ± 2.17^‡

15 mg/kg (loading)^†; 3 g before incision closure^‡

NP^†; NP^‡

Mu et al, [7]

China

RCT

TXA

Posterior lumbar decompression and fusion

Lumbar; degenerative disease

General; anesthesia

Intravenous; topical

54.20 ± 7.37^†; 51.77 ± 8.13^‡

45 (27/18)^† 39; (22/17)^‡

24.83 ± 1.95^†; 24.72 ± 1.82^‡

15 mg/kg + 1 mg/kg/h^†; 1 g before incision closure^‡

Hb < 70 g/L^†; Hb < 70 g/L^‡

Hui et al, [9]

China

RCT

TXA

Lumbar decompression and fusion

Lumbar; degenerative disease

General; anesthesia

Intravenous; topical

NP^†; NP^‡

NP^†; NP^‡

NP^†; NP^‡

10 mg/kg + 1 mg/kg/h^†; 0.5 g before incision closure^‡

NP^†; NP^‡

Wu et al, [6]

China

RCT

TXA

Posterior lumbar decompression and fusion

Lumbar; degenerative disease

General; anesthesia

Intravenous; topical

NP^†; NP^‡

NP^†; NP^‡

NP^†; NP^‡

100 ml (loading)^†; 20 ml before incision closure^‡

Hb ≤ 70 g/L^†; Hb ≤ 70 g/L^‡

Lu et al, [10]

China

RCT

TXA

One stage posterior surgery of thoracic spinal tuberculosis, interbody fusion and internal fixation

Thoracic spinal; tuberculosis

General; anesthesia

Intravenous; topical

NP^†; NP^‡

NP^†; NP^‡

NP^†; NP^‡

10 mg/kg (loading)^†; 10 mg/kg^‡

NP^†; NP^‡

Meng et al, [11]

China

RCT

TXA

Posterior lumbar decompression and fusion

Lumbar; degenerative disease

General; anesthesia

Intravenous; topical

62.30 ± 5.40^†; 61.10 ± 5.80^‡

40 (23/17)^†; 40 (24/16)^‡

25.20 ± 5.30^†; 27.50 ± 4.70^‡

15 mg/kg (loading)^†; NP^‡

Hb ≤ 70 g/L^†; Hb ≤ 70 g/L^‡

Duan et al, [12]

China

RCT

TXA

Posterior cervical single-door laminoplasty

Cervical; spondylitis myelopathy

General; anesthesia

Intravenous; topical

57.00 ± 4.11^†; 57.10 ± 4.82^‡

30 (17/13)^†; 30 (15/15)^‡

NP^†; NP^‡

10 mg/kg (loading)^†; 1 g before incision closure^‡

Hb ≤ 80 g/L^†; Hb ≤ 80 g/L^‡

Zheng et al, [13]

China

RCT

TXA

Multisegment, thoracolumbar posterior bone graft fusion and internal fixation

Lumbar; degenerative disease

General; anesthesia

Intravenous; topical

NP^†; NP^‡

NP^†; NP^‡

NP^†; NP^‡

100 ml (loading)^†; 100 ml before incision closure^‡

NP^†; NP^‡

^†Intravenous group; ^‡Topical group. RCT, randomized controlled trial; TXA, tranexamic acid; M, male; F, female; BMI, body mass index; NP, not provided.