Effect and safety of intravenous drip combined with local infiltration of tranexamic acid on blood loss in patients with single-segment lumbar spinal stenosis after unilateral biportal endoscopic unila-teral laminectomy for bilateral decompression

Objective To investigate the effect and safety of intravenous drip combined with local infiltration of trane-xamic acid on blood loss in patients with single-segment lumbar spinal stenosis (LSS) undergoing unilateral biportal endoscopic unilateral laminectomy for bilateral decompression (UBE-ULBD). Methods The patients with single-segment LSS who met the inclusion criteria and underwent UBE-ULBD from March 2023 to August 2024 were enrolled and randomly divided into intravenous group (tranexamic acid [TXA] was administered via intravenous drip before incision closure), combined group (TXA was administered via intravenous drip combined with local infiltration before incision closure), and control group (the incision was sutured directly), with 38 patients in each group. The three groups were compared in terms of general clinical data, postoperative drainage volume, the reduction in hemoglobin (HGB) (the difference between the level of HGB before surgery and the level of HGB on day 1 after surgery), postoperative coagulation markers, length of postoperative hospital stay, and complications. Results Compared with the intravenous group and the control group, the combined group had a significant reduction in postoperative drainage volume, and the combined group had a significantly lower postoperative drainage volume than the intravenous group (F=44.364,tLSD=2.717-7.194,P0.05). At the 3-month follow-up after surgery, no related complications were observed in any group. Conclusion Intravenous drip and local infiltration of TXA can significantly reduce postoperative blood loss in patients with single-segment LSS undergoing UBE-ULBD surgery, without exerting a significant impact on coagulation function or increasing the incidence rate of postoperative complications.