Local Tranexamic Acid During Decompression-Stabilization-Fusion in Lumbar Spinal Canal Stenosis: Effects on Coagulation and Postoperative Drainage
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Decompression-stabilization-fusion for lumbar spinal canal stenosis is frequently associated with considerable perioperative bleeding. Local tranexamic acid may improve surgical hemostasis while limiting systemic exposure. This study evaluated the effect of local tranexamic acid solution applied for 5 minutes to the operative field on postoperative prothrombin time, activated partial thromboplastin time, 24-hour drain volume, and drain duration in patients undergoing decompression-stabilization-fusion. This quasi-experimental comparative study included 52 patients with lumbar spinal canal stenosis who underwent decompression-stabilization-fusion at RSUP Prof. Dr. I.G.N.G. Ngoerah, Bali, Indonesia. Patients were divided into a local tranexamic acid group (n=26) and a control group without tranexamic acid application (n=26). Postoperative prothrombin time, activated partial thromboplastin time, 24-hour drain volume, and drain duration were compared between groups using the independent t-test or Mann-Whitney U test, with p<0.05 considered statistically significant. Postoperative prothrombin time did not differ significantly between the control and tranexamic acid groups (median 10.10 [9.70-14.90] vs. 10.55 [9.90-12.10] seconds; p=0.240). Activated partial thromboplastin time was also comparable between groups (median 25.80 [12.10-35.90] vs. 25.45 [18.50-29.70] seconds; p=0.869). The tranexamic acid group had significantly lower 24-hour drain volume than the control group (168.46±39.86 vs. 251.00±59.70 mL; p<0.001) and shorter drain duration (median 2.00 [2.00-3.00] vs. 4.00 [3.00-7.00] days; p<0.001). Local tranexamic acid application reduced postoperative drainage and shortened drain use without significantly altering postoperative prothrombin time or activated partial thromboplastin time. Keywords: Tranexamic acid; lumbar spinal canal stenosis; decompression-stabilization-fusion; prothrombin time; activated partial thromboplastin time; postoperative drainage.
Institution: Udayana University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7166328749