Antifibrinolytics reduce blood loss in adult spinal deformity surgery: a prospective, randomized controlled trial.

Abstract:

STUDY DESIGN:This is a prospective, randomized, double-blinded comparison of tranexamic acid (TXA), epsilon aminocaproic acid (EACA), and placebo used intraoperatively in patients with adult spinal deformity. OBJECTIVE:The purpose of this study was to provide high-quality evidence regarding the comparative efficacies of TXA, EACA, and placebo in reducing blood loss and transfusion requirements in patients undergoing posterior spinal fusion surgery. SUMMARY OF BACKGROUND DATA:Spine deformity surgery usually involves substantial blood loss. The antifibrinolytics TXA and EACA have been shown to improve hemostasis in large blood loss surgical procedures. METHODS:Fifty-one patients undergoing posterior spinal fusion of at least 5 levels for correction of adult spinal deformity were randomized to 1 of 3 treatment groups. Primary outcome measures included intraoperative estimated blood loss, total loss, (estimated blood loss + postoperative blood loss), and transfusion rates. RESULTS:Patients received TXA (n = 19), EACA (n = 19), or placebo (n = 13) in the operating room (mean ages: 60, 47, and 43 yr, respectively); TXA patients were significantly older and had larger estimated blood volumes than both other groups. Total losses were significantly reduced for EACA versus control, and there was a demonstrable but nonsignificant trend toward reduced intraoperative blood loss in both antifibrinolytic arms versus control. EACA had significant reductions in postoperative blood transfusions versus TXA. CONCLUSION:The findings in this study support the use of antifibrinolytics to reduce blood loss in posterior adult spinal deformity surgery. LEVEL OF EVIDENCE:1.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Peters A,Verma K,Slobodyanyuk K,Cheriyan T,Hoelscher C,Schwab F,Lonner B,Huncke T,Lafage V,Errico T

doi

10.1097/BRS.0000000000000799

subject

Has Abstract

pub_date

2015-04-15 00:00:00

pages

E443-9

issue

8

eissn

0362-2436

issn

1528-1159

pii

00007632-201504150-00004

journal_volume

40

pub_type

杂志文章,随机对照试验

相关文献

SPINE文献大全
  • Prospective design delineation and subsequent in vitro evaluation of a new posterior dynamic stabilization system.

    abstract:STUDY DESIGN:Finite element and in vitro study. OBJECTIVE:Finite element calculations to delineate a dynamic fixator and confirmation with an in vitro experiment. SUMMARY AND BACKGROUND DATA:In the last few years, there was a paradigm shift from rigid to dynamic fixation of spinal segments. However, some so-called dy...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e3181920e9c

    authors: Wilke HJ,Heuer F,Schmidt H

    更新日期:2009-02-01 00:00:00

  • Neurologic complications of surgery for cervical compression myelopathy.

    abstract::Neurologic complications resulting from surgery for 384 cases of cervical myelopathy (cervical soft disc herniation, spondylosis, ossification of the posterior longitudinal ligament) were reviewed. Surgical procedures performed included 134 anterior interbody fusions (Cloward or Robinson-Smith technique), 70 subtotal ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199111000-00006

    authors: Yonenobu K,Hosono N,Iwasaki M,Asano M,Ono K

    更新日期:1991-11-01 00:00:00

  • Perioperative Catheter Use as a Risk Factor for Surgical Site Infection After Cervical Surgery: An Analysis of 39,893 Patients.

    abstract:STUDY DESIGN:Retrospective cohort study. OBJECTIVE:To demonstrate the relationship between perioperative use of catheters and the incidence of surgical site infection (SSI) after cervical spine surgery, after adjusting for patient's age, severity of comorbidity, surgical approach, and use of instrumentation. SUMMARY ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000002790

    authors: Tamai K,Wang C,Heindel P,Paholpak P,Buser Z,Wang JC

    更新日期:2019-02-01 00:00:00

  • Is it possible to evaluate the parameters of cervical sagittal alignment on cervical computed tomographic scans?

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:The purpose of this study was to analyze the relationship of the parameters of cervical sagittal alignment between those obtained from cervical CT and those obtained from radiography, as well as to determine which parameter would help predict physiological lordosis of the ce...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000281

    authors: Jun HS,Chang IB,Song JH,Kim TH,Park MS,Kim SW,Oh JK

    更新日期:2014-05-01 00:00:00

  • Isolated anterior arch fracture of the atlas: child case report.

    abstract:STUDY DESIGN:The authors report a case of an atlas fracture at the anterior arch. OBJECTIVE:To discuss the difficulty in diagnosing this type fracture. SUMMARY OF BACKGROUND DATA:Fractures of the atlas are not uncommon, and actually constitute 10% of all cervical spine injuries in adults. However, in the pediatric po...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200201150-00021

    authors: Bayar MA,Erdem Y,Ozturk K,Buharali Z

    更新日期:2002-01-15 00:00:00

  • The natural history of degeneration of the lumbar and cervical spines: a systematic review.

    abstract:STUDY DESIGN:Systematic review. OBJECTIVE:To determine the population risk of radiographical degeneration in the lumbar and cervical spine as well as the risk of adjacent segment pathology (ASP) among patients who receive and do not receive (but were eligible for) fusion for lumbar or cervical degeneration. SUMMARY O...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31826cac62

    authors: Lee MJ,Dettori JR,Standaert CJ,Brodt ED,Chapman JR

    更新日期:2012-10-15 00:00:00

  • An Insight Into the Health-Related Quality of Life of Adolescent Idiopathic Scoliosis Patients Who Are Braced, Observed, and Previously Braced.

    abstract:STUDY DESIGN:Prospective cross-sectional study. OBJECTIVE:To determine the health-related quality of life (HRQoL) of adolescent idiopathic scoliosis (AIS) patients undergoing bracing, previously braced and observation only. SUMMARY OF BACKGROUND DATA:HRQoL is an important treatment outcome measure for AIS. A poor HRQ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000002918

    authors: Cheung PWH,Wong CKH,Cheung JPY

    更新日期:2019-05-15 00:00:00

  • The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments.

    abstract:STUDY DESIGN:A retrospective study was performed of 182 revisions on failed back surgery syndrome from the years 1965 to 1990. OBJECTIVE:To analyze the reasons for failure of primary discectomy, the outcome of the revisions, and factors that influenced those outcomes. SUMMARY OF BACKGROUND DATA:The reported reinterve...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199603010-00017

    authors: Fritsch EW,Heisel J,Rupp S

    更新日期:1996-03-01 00:00:00

  • The comparative study of magnetic resonance angiography diagnosis and pathology of blunt vertebral artery injury.

    abstract:STUDY DESIGN:Observational and comparative study of the vertebral artery injury detected by 2-dimensional (2-D) time-of-flight magnetic resonance angiography (MRA) for admitting patients. Construct a strike-induced flexion injury model of cervical spine with blunt vertebral artery injury in dogs. OBJECTIVES:To evaluat...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.brs.0000231722.86887.93

    authors: Ren X,Wang W,Zhang X,Pu Y,Wang M,Jiang T

    更新日期:2006-08-15 00:00:00

  • Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; however, deformities differ between age groups.

    abstract:STUDY DESIGN:Multicenter, prospective analysis of consecutive patients with adult spinal deformity (ASD). OBJECTIVE:Identify age-related radiographical parameters associated with poor health-related quality of life (HRQOL) and treatment preferences for ASD. SUMMARY OF BACKGROUND DATA:Patients with ASD report discrepa...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000414

    authors: Fu KM,Bess S,Shaffrey CI,Smith JS,Lafage V,Schwab F,Burton DC,Akbarnia BA,Ames CP,Boachie-Adjei O,Deverin V,Hart RA,Hostin R,Klineberg E,Gupta M,Kebaish K,Mundis G,Mummaneni PV,International Spine Study Group.

    更新日期:2014-08-01 00:00:00

  • Ischemic orbital compartment syndrome after posterior spinal surgery.

    abstract:STUDY DESIGN:Case report. OBJECTIVE:To describe a patient with ischemic orbital compartment syndrome after undergoing spinal surgery in a prone position. SUMMARY OF BACKGROUND DATA:Ocular complications after nonocular surgery are devastating. The most common etiology is ischemic optic neuropathy. Orbital compartment ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31817c55c2

    authors: Yu YH,Chen WJ,Chen LH,Chen WC

    更新日期:2008-07-15 00:00:00

  • Intervertebral foramen venous obstruction. A cause of periradicular fibrosis?

    abstract::Disc herniation into the intervertebral foramen (IVF) or osteophytic outgrowths from the margins of the apophyseal joints that project into the IVF may compress the neural structures, but in this cadaveric study of 160 lumbar foramens (age range, 35-91 years), the authors have found that they were much more commonly a...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198906000-00002

    authors: Hoyland JA,Freemont AJ,Jayson MI

    更新日期:1989-06-01 00:00:00

  • Lower preoperative Hounsfield unit measurements are associated with adjacent segment fracture after spinal fusion.

    abstract:STUDY DESIGN:Retrospective case-control study. OBJECTIVE:To determine the association of Hounsfield unit (HU) measurements with adjacent segment fractures after spinal fusion. SUMMARY OF BACKGROUND DATA:Adjacent segment fracture is a potentially devastating complication after spinal fusion surgery in osteoporotic pat...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31826ff084

    authors: Meredith DS,Schreiber JJ,Taher F,Cammisa FP Jr,Girardi FP

    更新日期:2013-03-01 00:00:00

  • Adult Spinal Deformity Patients Recall Fewer Than 50% of the Risks Discussed in the Informed Consent Process Preoperatively and the Recall Rate Worsens Significantly in the Postoperative Period.

    abstract:STUDY DESIGN:Recall of the informed consent process in patients undergoing adult spinal deformity surgery and their family members was investigated prospectively. OBJECTIVE:To quantify the percentage recall of the most common complications discussed during the informed consent process in adult spinal deformity surgery...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000964

    authors: Saigal R,Clark AJ,Scheer JK,Smith JS,Bess S,Mummaneni PV,McCarthy IM,Hart RA,Kebaish KM,Klineberg EO,Deviren V,Schwab F,Shaffrey CI,Ames CP

    更新日期:2015-07-15 00:00:00

  • Correlations of spinal mobility with degree of chronic low back pain after correction for age and anthropometric factors.

    abstract::Correlations of age, height, weight, lordosis, and kyphosis with noninvasive spinal mobility measurements were studied in 301 men and 175 women, aged 35-55 years, who suffered from chronic or recurrent low back pain (LBP). Correlations of the different spinal movements with the degree of LBP were analyzed, with correc...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198706000-00008

    authors: Mellin G

    更新日期:1987-06-01 00:00:00

  • Genetic linkage localizes an adolescent idiopathic scoliosis and pectus excavatum gene to chromosome 18 q.

    abstract:STUDY DESIGN:A single large family, in which adolescent idiopathic scoliosis (AIS) and pectus excavatum (PE) segregate as an autosomal dominant condition, was evaluated. Genome-wide linkage analysis and candidate gene sequencing were performed. OBJECTIVE:To map the disease-causing locus in a large white family in whic...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31818b88a5

    authors: Gurnett CA,Alaee F,Bowcock A,Kruse L,Lenke LG,Bridwell KH,Kuklo T,Luhmann SJ,Dobbs MB

    更新日期:2009-01-15 00:00:00

  • Adaptation of the Oswestry Disability Index to Kannada Language and Evaluation of Its Validity and Reliability.

    abstract:STUDY DESIGN:A translation, cross-cultural adaptation, and validation study. OBJECTIVE:The aim of this study was to translate, adapt cross-culturally, and validate the Kannada version of the Oswestry Disability Index (ODI). SUMMARY OF BACKGROUND DATA:Low back pain is recognized as an important public health problem. ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000001368

    authors: Mohan V,G S P,Meravanigi G,N R,Yerramshetty J

    更新日期:2016-06-01 00:00:00

  • The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery.

    abstract:STUDY DESIGN:A retrospective cohort analysis. OBJECTIVE:The aim of this study was to assess whether duration of symptoms (DOS) has an effect on clinical outcomes in patients undergoing lumbar decompression. SUMMARY OF BACKGROUND DATA:The success of surgical interventions for lumbar spinal stenosis varies depending on...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000002818

    authors: Movassaghi K,Basques BA,Louie PK,Khan JM,Derman PB,Nolte MT,Paul JC,Goldberg EJ,An HS

    更新日期:2019-03-01 00:00:00

  • Automatic Cobb angle determination from radiographic images.

    abstract:STUDY DESIGN:Automatic measurement of Cobb angle in patients with scoliosis. OBJECTIVE:To test the accuracy of an automatic Cobb angle determination method from frontal radiographical images. SUMMARY OF BACKGROUND DATA:Thirty-six frontal radiographical images of patients with scoliosis. METHODS:A modified charged pa...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e3182a0c7c3

    authors: Sardjono TA,Wilkinson MH,Veldhuizen AG,van Ooijen PM,Purnama KE,Verkerke GJ

    更新日期:2013-09-15 00:00:00

  • Preventive interventions for back and neck pain problems: what is the evidence?

    abstract:STUDY DESIGN:A review of controlled trials. OBJECTIVES:To determine which interventions are used to prevent back and neck pain problems as well as what the evidence is for their utility. SUMMARY OF BACKGROUND DATA:Given the difficulty in successfully treating long-term back and neck pain problems, there has been a ca...

    journal_title:Spine

    pub_type: 临床试验,杂志文章,评审

    doi:10.1097/00007632-200104010-00019

    authors: Linton SJ,van Tulder MW

    更新日期:2001-04-01 00:00:00

  • Influence of macrophage infiltration of herniated disc tissue on the production of matrix metalloproteinases leading to disc resorption.

    abstract:STUDY DESIGN:Herniated lumbar disc specimens were cocultured with peripheral blood mononuclear cells, and cells isolated from extruded disc were cultured to study the production of matrix metalloproteinases. OBJECTIVE:To investigate the role of peripheral blood mononuclear cells infiltrating extruded discs and disc-de...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200107150-00004

    authors: Doita M,Kanatani T,Ozaki T,Matsui N,Kurosaka M,Yoshiya S

    更新日期:2001-07-15 00:00:00

  • The impact of esophagus retraction on early dysphagia after anterior cervical surgery: does a correlation exist?

    abstract:STUDY DESIGN:Prospective study of 92 patients who underwent anterior cervical surgery. Intraoperative esophagus retraction and postoperative dysphagia were recorded and evaluated. OBJECTIVE:Early dysphagia after anterior cervical discectomy and fusion is an underestimated side effect. The aim of this study was to inve...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.brs.0000261627.04944.cf

    authors: Papavero L,Heese O,Klotz-Regener V,Buchalla R,Schröder F,Westphal M

    更新日期:2007-05-01 00:00:00

  • Behavioral responses to examination. A reappraisal of the interpretation of "nonorganic signs".

    abstract::Waddell et al in 1980 developed a standardized assessment of behavioral responses to examination. The signs were associated with other clinical measures of illness behavior and distress, and are not simply a feature of medicolegal presentations. Despite clear caveats about the interpretation of the signs, they have be...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199811010-00025

    authors: Main CJ,Waddell G

    更新日期:1998-11-01 00:00:00

  • The role of inflammation in lumbar pain.

    abstract::The clinical features of many cases of low back pain is inadequately explained by anatomic abnormalities alone. A pathophysiologic mechanism that includes a combination of mechanical and biochemical factors is an alternative explanation that is accompanied by less paradox than a purely structural paradigm. A potential...

    journal_title:Spine

    pub_type: 杂志文章,评审

    doi:10.1097/00007632-199508150-00013

    authors: Saal JS

    更新日期:1995-08-15 00:00:00

  • Vertebrodiatasis experimental lengthening of the juvenile goat spine.

    abstract::The purpose of this study is to describe the biology of spinal lengthening (vertebrodiatasis) in a juvenile goat model. A small Orthofix dynamic fixator was affixed to 5.5 mm pedicular halfpins placed bilaterally at T12, L1, L5 and L6 in six juvenile goats. Distraction was performed across vertebral endplates between ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199309000-00008

    authors: Stefko RM,Cain JE Jr,Lauerman WC 2nd,Brann C,Platenburg RC,Pyka R

    更新日期:1993-09-15 00:00:00

  • Neurophysiological Effects of High Velocity and Low Amplitude Spinal Manipulation in Symptomatic and Asymptomatic Humans: A Systematic Literature Review.

    abstract:STUDY DESIGN:Systematic review. OBJECTIVE:To summarize the evidence of neurophysiological effects of spinal manipulative therapy (SMT) with a high velocity low amplitude thrust (HVLA-SMT) in asymptomatic and symptomatic humans. SUMMARY OF BACKGROUND DATA:HVLA-SMT is effective in reducing back pain, but its mode of ac...

    journal_title:Spine

    pub_type: 杂志文章,meta分析

    doi:10.1097/BRS.0000000000003013

    authors: Wirth B,Gassner A,de Bruin ED,Axén I,Swanenburg J,Humphreys BK,Schweinhardt P

    更新日期:2019-08-01 00:00:00

  • Comparison of the flat torso versus the elevated torso shoulder pad removal techniques in a cadaveric cervical spine instability model.

    abstract:STUDY DESIGN:Controlled laboratory study in a cadaveric model. OBJECTIVE:To determine if removing shoulder pads using the elevated torso technique generated less spinal segment motion than using the flat torso method. SUMMARY OF BACKGROUND DATA:Guidelines for care of the injured football player with a suspected spina...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31819794e7

    authors: Horodyski M,DiPaola CP,DiPaola MJ,Conrad BP,Del Rossi G,Rechtine GR 2nd

    更新日期:2009-04-01 00:00:00

  • Three-dimensional computed tomography-based, personalized drill guide for posterior cervical stabilization at C1-C2.

    abstract:STUDY DESIGN:Cadaver and preliminary clinical study. OBJECTIVES:To enhance the precision of screw positions for posterior transarticular fixations according to Magerl at C1-C2. SUMMARY OF BACKGROUND DATA:The vertebral arteries are at risk during the Magerl operation and may be damaged in up to 4.1% of cases. Even int...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200106150-00017

    authors: Goffin J,Van Brussel K,Martens K,Vander Sloten J,Van Audekercke R,Smet MH

    更新日期:2001-06-15 00:00:00

  • Atlantoaxial instability in os odontoideum with myelopathy.

    abstract:STUDY DESIGN:This study analyzed the correlation between the atlantoaxial instability (especially sagittal plane rotatory instability) and myelopathy. Thirty-four patients with os odontoideum were reviewed in clinical symptoms and radiographs. OBJECTIVES:The results were correlated to provide a rationale for the genes...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199606150-00007

    authors: Watanabe M,Toyama Y,Fujimura Y

    更新日期:1996-06-15 00:00:00

  • Neurologic recovery associated with anterior decompression of spine fractures at the thoracolumbar junction (T12-L1).

    abstract::Between 1981 and 1990, twenty-two patients with incomplete neurologic deficits after thoracolumbar junction fractures were treated by anterior decompression and stabilization. Two patients were unavailable for follow-up examination, eleven underwent spinal canal decompression within 48 hours of injury (Group A); and n...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199208001-00019

    authors: Clohisy JC,Akbarnia BA,Bucholz RD,Burkus JK,Backer RJ

    更新日期:1992-08-01 00:00:00