Posterior spinal surgery for adult deformity is associated with high incidence of blood loss
and need for blood transfusion and intraoperative blood salvage, with associated increased
cost and risk for perioperative complications. Tranexamic acid (TXA) is relatively
inexpensive anti-fibrinolytic agent that has been proven effective for decreasing
intraoperative blood loss in various surgical specialties. Intravenous TXA (ivTXA) is
routinely used at our institution for adult spinal deformity cases. Meanwhile, topical TXA
(tTXA) is an attractive alternative/adjunct to ivTXA used with good results in orthopedic
arthroplasty and cardiac surgery. To the investigators' knowledge, no data exists in the
literature on the use of tTXA in either adult or pediatric spinal deformity surgery. The goal
of this study is to determine the role tTXA has an adjunct to ivTXA in decreasing
perioperative blood loss, drainage, transfusion requirements and length of stay following
adult deformity spine surgery.