Open AccessMarijuana Use is Not a Contraindication for Tranexamic Acid Utilization in Lumbar Spine Surgery
Author(s) -
Andre Jakoi,
Gregory J. Kirchner,
Alexander M. Lieber,
Amrit Khalsa
Publication year - 2022
Publication title -
global spine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.398
H-Index - 26
eISSN - 2192-5690
pISSN - 2192-5682
DOI - 10.1177/21925682211049166
Subject(s) - medicine , cohort , retrospective cohort study , tranexamic acid , deep vein , pulmonary embolism , lumbar , packed red blood cells , surgery , cohort study , thrombosis , contraindication , myocardial infarction , blood transfusion , blood loss , pathology , alternative medicine
Study Design Retrospective cohort studyObjective The purpose of this study was to evaluate safety in lumbar spinal fusion with tranexamic acid (TXA) utilization in patients using marijuana.Methods This was a retrospective cohort study involving a single surgeon’s cases of 1 to 4 level lumbar fusion procedures. Two hundred and ninety-four patients were followed for ninety days post-operatively. Consecutive patients were self-reported for daily marijuana use (n = 146) and compared to a similar cohort of patients who denied usage of marijuana (n = 146). Outcomes were collected, which included length of stay (LOS), estimated blood loss (EBL), post-operative myocardial infarction, seizures, deep venous thrombosis, pulmonary embolus, death, readmission, need for further surgery, infection, anaphylaxis, acute renal injury, and need for blood product transfusion.Results Patients in the marijuana usage cohort had similar age (58.9 years ±12.9 vs 58.7 years ±14.8, P = .903) and distribution of levels fused ( P = .431) compared to the non-usage cohort. Thromboembolic events were rare in both groups (marijuana usage: 1 vs non-usage: 2). Compared to the non-usage cohort, the marijuana usage cohort had a similar average EBL (329.9 ± 298.5 mL vs 374.5 ± 363.8 mL; P = .254). Multivariate regression modeling demonstrated that neither EBL (OR 1.27, 95% CI 0.64-2.49) nor need for transfusion (OR 1.56, 95% CI 0.43-5.72) varied between cohorts. The non-usage cohort had twice the risk of prolonged LOS compared to the marijuana usage cohort (OR 2.05, 95% CI 1.15-3.63).Conclusion Marijuana use should not be considered a contraindication for TXA utilization in lumbar spine surgery.