Letter to editor regarding "The Efficacy and Safety of Topical Saline Irrigation with Tranexamic Acid on Perioperative Blood Loss in Patients Treated with PELD".

Tranexamic Acid: A Controversial Oasis in the Desert of Blood Loss Management

The use of tranexamic acid (TXA) in endoscopic spine surgery is a controversial topic. This letter to the editor raises concerns about the safety and efficacy of topical TXA, highlighting potential risks that may outweigh the benefits. The authors question the reported blood loss figures and the use of TXA in a procedure with already minimal blood loss. It’s like questioning the use of a heavy camel pack on a journey across a relatively smooth desert terrain.

The Potential Risks of Topical TXA

The authors express concern about the potential neurotoxicity and epileptogenic properties of TXA when applied to central nervous system (CNS) tissue. This is a significant risk, especially in endoscopic spine surgery, where dural tears can go unnoticed and pose a risk of CNS exposure to TXA. It's like finding a hidden oasis that is contaminated with poisonous water.

A Call for Further Research and Caution

The authors call for further research and caution in the use of topical TXA, particularly in endoscopic spine surgery. They suggest that the risks may outweigh the benefits, especially given the minimal blood loss associated with the procedure. It's like weighing the benefits of a rare desert bloom against the potential for a deadly scorpion bite.

Dr.Camel's Conclusion

This letter to the editor raises important questions about the use of topical TXA in endoscopic spine surgery. It highlights the need for careful consideration of the potential risks and benefits, particularly in a procedure where blood loss is minimal. Further research is needed to determine the optimal use of TXA in this context, ensuring a safe and effective journey across the desert of spinal surgery.