Objective: To study the effect of different use modes of tranexamic acid on patients undergoing single-segment posterior lumbar vertebral fusion. Methods: Ninety patients undergoing posterior lumbar interbody fusion (PLIF) were divided into groups A, B and C, with 30 patients in each group. Patients in group A were intravenously injected with 100 mL tranexamic acid (TXA) solution (15 mg/kg TXA: 100 mL 0.9 % NaCl solution) 15 min before operation. Patients in group B were soaked in 20 mL TXA solution (1 g TXA: 20 mL 0.9 % NaCl solution) for 5 min before suturing the deep fascia, and unilateral drainage tube was placed after washing. Patients in group C were injected with 20 mL TXA solution (1 g TXA: 20 mL 0.9 % NaCl solution) into the incision along the drainage tube. The clinical indexes and postoperative complications of each group were observed. Results: (1)Comparison of hemoglobin and hematocrit: those in group A were higher than those in group B and group C at 1 day after operation (P＜0.05); those in group C were higher than those in group A and group B at 3 days after operation (P＜0.05). (2)Comparison of total blood loss, postoperative drainage volume and hidden blood loss: those in group C were lower than those in group A and group B (P＜0.05). (3)Comparison of intraoperative blood loss: that in group A was lower than that in group B and group C (P＜0.05). (4) There was no significant difference in D-dimer and coagulation five items at 1 and 3 days after operation (P＞0.05). (5) There was no significant difference in postoperative complications among three groups(P＞0.05) . Conclusion: Topical application of TXA combined with drainage tube clamping for 1 h after single-segment PLIF can reduce the total perioperative blood loss, postoperative drainage and hidden blood loss in patients, and the safety is comparable to that of traditional intravenous drip, which is worthy of clinical promotion.