Three hundred ten patients undergoing traditional lumbar spinal fusion were randomized into four groups: Group A (placebo; no tranexamic acid [TXA] or temperature intervention, n=78), Group B (TXA only, n=77), Group C (TXA with temperature intervention, n=77), and Group D (temperature intervention only, n=78). The primary outcomes were intraoperative, postoperative, and total blood loss. Secondary outcomes included hemoglobin levels on postoperative day 1 (POD1), blood transfusion rates, prothrombin time, length of hospital stay, and incidence of deep vein thrombosis or pulmonary embolism. Outcomes were assessed up to 3 months postoperatively. Overall, the results demonstrated that Group C had significantly lower blood loss, higher hemoglobin levels on POD1, reduced transfusion rates, and shorter hospital stays compared to the other groups (P < .05). The findings suggest that combining TXA and temperature intervention enhances perioperative outcomes without increasing thrombotic complications.