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Posterior lumbar interbody fusion requires stripping the multifidus muscle, destroying a large amount of cancellous bone and damaging the posterior spinal venous plexus. Typically, surgical trauma is extensive, the surgical duration is long, and the degree of bleeding is substantial. Excessive blood loss can compromise a patient's hemodynamic stability, elevate surgical risks, and cause damage to vital organs, potentially becoming life-threatening in severe cases. Tranexamic acid (TXA) is a lysine derivative that can inhibit fibrinolysis, reduce D-dimer production, and reduce inflammation. In this review, we discuss the application of and research progress on TXA regarding its mechanism of action, mode of administration, timing, dose, safety, and economic benefits. The primary purpose of this review is to provide an essential reference for the administration of TXA during posterior lumbar interbody fusion surgery as well as a reference for future research.
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http://dx.doi.org/10.3389/fmed.2025.1612281 | DOI Listing |
Proc Inst Mech Eng H
September 2025
IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
Low back pain is estimated to affect more than 70% of the population. Recently, interspinous posterior devices are gaining attention as a less invasive alternative to the traditional pedicle screw systems. However, since most of these devices are not suitable for the L5-S1 segment, the goals for this study are to design a tailored fixation system for the L5-S1 level and to study its effects on the degenerated spine.
View Article and Find Full Text PDFGlobal Spine J
September 2025
Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
DesignRandomized Controlled Trial.ObjectivePostoperative pain after lumbar spine surgery remains a clinical challenge. Fluoroscopy-guided erector spinae plane block (ESPB) has been proposed as a feasible technique for reducing pain and opioid use, particularly when ultrasound guidance is not available.
View Article and Find Full Text PDFJ Neurosurg Spine
September 2025
22Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, DC.
Objective: Variations exist among surgeons in the treatment of recurrent lumbar disc herniation (LDH), generating major issues in decision-making models. The authors aimed to identify international nuances in surgical treatment patterns, highlight the differences in responses in each country group and different treatment trends across countries, and identify factors that influence surgical decisions.
Methods: An online survey with preformulated answers was submitted to 292 orthopedic surgeons and 223 neurosurgeons from 16 countries regarding 3 clinical vignettes (recurrence without low back pain, recurrence with severe low back pain, and recurrence with 2-level disc disease).
Eur Spine J
September 2025
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Purpose: Intraoperative bleeding remains a major challenge in lumbar spine surgery, with conventional assessment methods lacking standardization. The Validated Intraoperative Bleeding Severity Scale (VIBe) is a structured five-grade tool developed to objectively assess bleeding severity across surgical fields. This study evaluated the clinical utility of VIBe in lumbar spinal fusion by comparing it with conventional bleeding metrics across various hemostatic strategies, including hypotensive anesthesia and local hemostatic agent use.
View Article and Find Full Text PDFJ Lifestyle Med
August 2025
Department of Microbiology, Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University (SRHU), Dehradun, India.
Background: Hamstring flexibility is essential for preventing and treating musculoskeletal injuries, particularly low back pain. Self-myofascial release (SMR) of the plantar fascia, a technique involving a tennis ball, is often employed to enhance flexibility along the posterior "anatomy train." However, its specific effect on hamstring and lumbar spine flexibility remains uncertain.
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