The effect of tranexamic acid in perioperative blood loss control and its safety assessment in old patients with multiple lumbar spinal stenosis / 中国医师进修杂志

Objective To investigate the efficacy and safety of tranexamic acid in perioperative blood loss in old patients with multi-level lumbar spinal stenosis.Methods From January 2009 to September 2010,a total of 68 consecutive patients with multi-level lumbar spinal stenosis ( ≥65 years old) underwent posterior decompression,internal fixation and bone graft fusion who were randomly divided into group A and group B with 34 patients in each.The patients in group A received tranexamic acid and the patients in group B received an equal volume of normal saline.The amounts of intraoperative blood loss,postoperative wound drainage,blood transfusion,the number of the patients needing blood transfusion and hemoglobin,fibrinogen,prothrombin time and so on were examined preoperatively and 24 hours postoperatively.All the patients were observed for the clinical symptoms of deep vein thrombosis.Results The amounts of intraoperative blood loss,postoperative wound drainage,blood transfusion and the number of the patients needing blood transfusion in group A were significantly decreased than those in group B[ (641.1 ± 128.4) ml vs.(780.1 ± 107.3) ml,(228.80 ± 52.07) ml vs.(345.50 ±42.16) ml,(1.02 + 1.56) U vs.(2.89 ± 1.76) U,16 cases vs.28 cases ],there were significant differences between two groups (P ＜ 0.05 ).As for the value of postoperative hemoglobin concentration in group A [ ( 104.00 ± 4.87) g/L ] was significantly higher than that in group B [ (92.20 + 5.47 ) g/L ] (P ＜ 0.05 ).There were no significant differences in the levels of fibrinogen,prothrombin time,and activated partial thromboplastin time between two groups (P ＞ 0.05).No deep vein thrombosis was found 7 days postoperatively.Conclusion Tranexamic acid can be effectively used in spine surgery in old patients with multi-level lumbar spinal stenosis without increasing the risk of venous thrombosis.

Nonoperative Treatment of Thoracolumbar Fractures without Neurological Deficit / 中国康复理论与实践

@#Objective To evaluate the clinical effect of postural reduction and bracing on thoracolumbar fractures without neurological deficit.Methods21 patients with thoracolumbar fractures(T11～L2