{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:02:52Z","timestamp":1777006972074,"version":"3.51.4"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tranexamic acid (TXA) is a hemostatic agent used in posterior lumbar interbody fusion (PLIF). However, reports on its use in patients on preoperative anticoagulants are scarce. This study evaluates the safety and efficacy of preoperative 1\u202fg TXA in such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study retrospectively analyzed the medical records of patients who underwent PLIF and had received anticoagulants within 1\u202fweek before surgery between January 2021 and June 2023. After general anesthesia, at 15\u202fmin before skin incision, patients who received intravenous TXA were recorded as the observation group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f31), and those who did not were recorded as the control group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f29). The main observation indicators included surgical time, intraoperative blood loss (IBL), postoperative drainage volume (PDV), number of blood transfusions, red blood cell count (RBC), hemoglobin (HB), and hematocrit (HCT) on the postoperative 1st, 4th, 7th, and last-test days. The secondary observation indicators included postoperative incision healing, number of lower limb deep vein thrombosis (DVT), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), platelet count (PLT) and postoperative hospital stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The surgeries were successfully completed. The incisions healed as grade A, and no DVT occurred. The IBL and PDV in the observation group were significantly lower than those in the control group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.05). There were no significant differences between the two groups in surgical time or blood transfusions (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05). The multivariate linear regression analysis revealed that the surgical segment and TXA were independent influencing factors for IBL and PDV, while age, body mass index, gender, coexisting hypertension, disease type, and anticoagulant type were not. Subgroup multivariate analysis further confirmed that anticoagulant type was not an independent influencing factor of IBL or PDV. There were no statistically significant differences between the two groups in RBC, HB, or HCT at any postoperative time point (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05). There was no significant difference in postoperative PT, APTT, TT, FIB, PLT, or postoperative hospital stay between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients undergoing PLIF with preoperative anticoagulation, TXA administration appears safe and significantly reduces perioperative blood loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1729718","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:31:24Z","timestamp":1777005084000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and effectiveness of intravenous tranexamic acid for posterior lumbar interbody fusion in patients on preoperative anticoagulants: a retrospective case\u2013control study"],"prefix":"10.3389","volume":"13","author":[{"given":"Bing","family":"Qian","sequence":"first","affiliation":[{"name":"Emergency Medicine Department, Honghui Hospital, Xi\u2019an Jiaotong University","place":["Xi'an, Shaanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongqi","family":"Zhan","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shenshen","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Spine, Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]},{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoya","family":"Zhu","sequence":"additional","affiliation":[{"name":"Interventional Operating Room, Pingdingshan the Second People's Hospital","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangshu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Henan Provincial Third People's Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunzhi","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengli","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongke","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spine and Bone Oncology, General Hospital of Pingmei Shenma Medical Group","place":["Pingdingshan, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"Emergency Medicine Department, Honghui Hospital, Xi\u2019an Jiaotong University","place":["Xi'an, Shaanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","first-page":"2","article-title":"Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs","year":"2015","journal-title":"J Spine Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1097\/BRS.0000000000002207","article-title":"Trends, complications, and costs for hospital admission and surgery for lumbar spinal stenosis","volume":"42","author":"Machado","year":"2017","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4714","DOI":"10.1038\/s41598-022-27307-3","article-title":"The effect of intravenous unit-dose tranexamic acid on visible and hidden blood loss in 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(Lausanne)"},{"key":"ref7","first-page":"81","article-title":"Expert consensus on the application of tranexamic acid and anticoagulant for the enhanced recovery after orthopedic surgery in China","volume":"12","author":"Zhou","year":"2019","journal-title":"Chin J Bone Joint Surg"},{"key":"ref8","first-page":"43","article-title":"Effect of adequate amount of tranexamic acid before operation on blood loss and safety in posterior lumbar fusion with multiple segments","volume":"34","author":"Yuan","year":"2021","journal-title":"Chin J Blood Transfus"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4080","DOI":"10.2174\/15672050113109990202","article-title":"Co-drug strategy for promoting skin targeting and minimizing the transdermal diffusion of hydroquinone and tranexamic acid","volume":"20","author":"Hsieh","year":"2013","journal-title":"Curr Med Chem"},{"key":"ref10","first-page":"29","article-title":"The effect of aspirin on the blood losses of lumbar 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tranexamic acid in PLIF: a case control study","volume":"14","author":"Hao","year":"2024","journal-title":"Sci Rep"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.3389\/fmed.2026.1753809","article-title":"The impact of preoperative anticoagulant administration on postoperative coagulation function and blood loss following posterior lumbar interbody fusion: a case\u2013control study","volume":"13","author":"Zhan","year":"2026","journal-title":"Front Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/bto.0000000000000205","article-title":"Tranexamic acid: the new gold standard?","volume":"32","author":"Adigweme","year":"2017","journal-title":"Tech Orthop"},{"key":"ref16","first-page":"215","article-title":"Effect and safety of local medication of tranexamic acid on reducing postoperation blood loss inposterior lumbar fusion","volume":"18","author":"Xu","year":"2018","journal-title":"Lingnan Mod Clin 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Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1729718\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:31:43Z","timestamp":1777005103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1729718\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":23,"alternative-id":["10.3389\/fmed.2026.1729718"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1729718","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"article-number":"1729718"}}