Multicenter, Randomized Placebo-controlled Clinical Trial to Evaluate the Effect of Perioperative Use of Tranexamic Acid on Transfusion Requirements and Surgical Bleeding in Major Spine Surgery

Inclusion Criteria: * Patients ≥18 years old of both sexes * scheduled for complex spine surgery * ASA I-III * weighing more than 30 kg * body mass index \<30 kg/m2 * operated on in the participating hospitals * major spinal surgery * signed an informed consent form to be included in the study Exclusion Criteria: * a history of allergy or hypersensitivity to the agent used * receiving medication that can interfere with coagulation (acetylsalicylic acid, oral anticoagulants, or antiplatelet agents) * a history of frequent bleeding * plasma creatinine values \>1.5 mg/dL in the baseline analysis * platelet count less than 150,000/mm3 in the follow-up analysis * abnormal prothrombin time (INR \>1.5) or partial thromboplastin time (INR \>1.5) * a history of a thromboembolic episode before surgery * family history of thromboembolism * lack of consent to participate in the study * infectious disease, tumor or trauma of the spine as the reason for surgery * scheduled for surgery with an anterior and posterior surgical approach, whether sequential or on the same day