171 patients scheduled for an elective posterior thoracolumbar fusion were randomized to receive either intravenous or oral tranexamic acid (TXA). The primary outcome of interest was the reduction in hemoglobin. Secondary outcomes included calculated blood loss, hematocrit drop, drain output, transfusion rate, rate of thromboembolic complications, including deep vein thrombosis and pulmonary embolism, rate of infection, and the length of hospital stay. The results from the trial demonstrated equivalence of the oral TXA group compared to the IV TXA group for hemoglobin drop and calculated blood loss. Furthermore, no significant differences were observed between the two groups in volume of drain output, transfusion rate, thromboembolic complication rate, infection rate or length of hospital stay.