[Study on the safety and effectiveness of low-dose tranexamic acid in operation of multi-level continuous thoracic ossification of ligament flavum].

OBJECTIVE: To investigate the safety and effectiveness of low-dose tranexamic acid (TXA) in operation of multi-level continuous thoracic ossification of ligament flavum (TOLF). METHODS: A clinical data of 26 patients who underwent operation for multi-level continuous TOLF and met the selection criteria between July 2015 and January 2019 was retrospectively analyzed. Among them, 13 cases (group A) were received intravenous infusion of TXA (10 mg/kg) at 15 minutes before operation, and maintained the infusion at 1 mg/(kg·h) until the end of the operation; 13 cases (group B) were received the same dose of normal saline before and during operation. There was no significant difference in gender, age, body mass index, diseased segment, and preoperative hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, international normalized ratio (INR) between the two groups ( P>0.05). The hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, INR, the number of deep vein thrombosis of the lower extremities, operation time, intraoperative blood loss, postoperative drainage volume, total blood loss, and the time of drainage tube extubation in the two groups were recorded and compared. RESULTS: All operations in the two groups were successfully completed. Compared with group B, the operation time and time of drainage tube extubation in group A were shortened, and the intraoperative blood loss, postoperative drainage volume, and total blood loss were reduced. The differences between the two groups were significant ( P<0.05). None of the two groups received blood transfusion, and the hemoglobin level of group A at 24 hours after operation was significantly higher than that of group B ( t=5.062, P=0.000). The incisions in both groups healed and sutures were removed within 2 weeks after operation, and no complications occurred. There was no significant difference between the two groups in activated partial thromboplastin time, prothrombin time, INR, and platelet count at 24 hours after operation ( P>0.05). CONCLUSION: In multi-level continuous TOLF operation, intravenous administration of low-dose TXA can effectively reduce blood loss, shorten postoperative drainage time, and does not increase the risk of complications.

Base and treatment of the thoracic myelopathy caused by ossification of ligamentum flavum / 中国矫形外科杂志

The thoracic ossification of the ligamentum flavum(OLF)is usually located in the lower thoracic spine.Thoracic OLF has been widely recognized as a main cause of thoracic myelopathy.The pathogenesis of OLF is poorly understood.Because the thoracic OLF has many clinical manifestations and it is commonly combined with other spinal disorders,it is easy to be misdiagnosed or to be a delayed diagnosis.The surgical treatment of thoracic OLF has high risk and Serious complications.In this paper the pathogenesis,diagnosis and treatment of thoracic ossification of ligamentum flavum in recent years are reviewed.