Tranexamic Acid in Adult Spinal Deformity Surgery

Major spinal deformity surgery — such as correction of adult scoliosis involving five or more vertebrae — is associated with substantial blood loss, often requiring blood transfusions. This trial tests whether tranexamic acid, a drug that reduces bleeding by preventing blood clots from dissolving prematurely, can reduce blood loss and transfusion requirements in these large spinal operations. Reducing blood loss in spinal surgery has real benefits: fewer transfusions means lower infection risk, fewer transfusion reactions, shorter hospital stays, and potentially faster recovery. The study compares patients who receive tranexamic acid with those who receive standard care. You may be eligible if: - You are between 18 and 80 years old - You are scheduled for a long posterior spinal fusion of 5 or more levels for adult scoliosis or degenerative joint disease - Your fusion includes the pelvis You may NOT be eligible if: - You have kidney or liver insufficiency - You have a history of seizures - You have had a blood clot (stroke, TIA, DVT, or pulmonary embolism) within the past year - You have atrial fibrillation or coronary artery disease with a stent or heart attack within the past year - You have a bleeding disorder or are on anticoagulant medication that cannot be stopped before surgery - You are pregnant or breastfeeding - You have active cancer or leukemia Talk to your doctor to see if this trial is right for you.