Aim:This study compares haemostasis induced with tranexamic acid (TXA) and immunosuppression induced with infliximab (INF) as strategies to reduce epidural fibrosis (EF) in rat laminectomy model.
Material and Methods:Twenty-one male SpragueDawley rats were randomly assigned to three groups: control (no treatment), TXA-treated, and INF-treated (n=7 per group). Following L1L3 laminectomy, TXA (1020 mg/mL) and INF (1 mg/mL) were topically applied. Histopathological evaluation was conducted eight weeks postoperatively using Hematoxylin-Eosin (H&E) and Masson-Goldners Trichrome staining. Epidural fibrosis severity, fibroblast density, inflammatory cell infiltration, and neovascularization were analyzed.
Results:Histopathological analysis revealed significantly lower fibrosis scores in the TXA group compared to the INF and control groups (p < 0.05). TXA also reduced fibroblast proliferation, inflammatory cell infiltration, and collagen deposition, whereas INF exhibited moderate anti-fibrotic effects but was less effective than TXA. No systemic side effects were observed in either treatment group.
Conclusion:This study demonstrates that TXA prevents EF more effectively than INF following laminectomy. The findings also underscore that TXA is superior over INF in reducing EF. These results suggest that compared with INF-induced immunosuppression, TXA-induced haemostasis is the more effective strategy to minimise postoperative fibrosis in spinal surgery.