Adding topical tranexamic acid to IV tranexamic acid to reduce blood loss in spinal deformity surgery

You may qualify if

• Age 18-80
• Scheduled to undergo posterior long segment ( ≥ 5 levels) posterior spinal fusion for adult scoliosis or degenerative joint diseae
• + fusion to pelvis

You can't join if

• Surgical factors:; Anterior Approach; Presence or history of dural tear without repair as evidenced by pseudomeningocele on MRI imaging or by intraoperative exploration; Patients donating autologous blood preoperatively
• Diagnosis of renal (Cr>1.5 or CrCl <30ml/min) or hepatic insufficiency (AST, ALT 2x upper limit of normal)
• Diagnosis of seizure disorder or prior seizure
• History of thromboembolic events (CVA, TIA, DVT, PE) if within 1 year of surgery
• Hypercoagulability (e.g. antiphospholipid syndrome)
• History of coronary artery disease (stent, MI, +stress test) within 1 year of surgery
• Atrial fibrillation
• Concurrent anticoagulation therapy that cannot be discontinued within 3 days before surgery (Coumadin, plavix, LVX)
• Concurrent anticoagulation with ASA 325 that cannot be discontinued 10 days before surgery
• Bleeding disorder or abnormal preoperative coagulation profile (as identified by a preoperative platelet count of <100,000/mm3, an international normalized ratio of >1.4, or a prolonged partial thromboplastin time >1.4 times normal)
• Preexisting anemia <10 g/dL
• Color blindness or disturbance of color vision
• Leukemia or active cancer
• Religious restrictions on blood transfusion
• Pregnancy or women who are lactating/breastfeeding