Hemostasis Versus Immunosuppression in Preventing Postlaminectomy Epidural Fibrosis: An Experimental Study in Rats


KÖKSAL V., MERCANTEPE T., Tümkaya L.

Turkish Neurosurgery, cilt.36, sa.2, ss.229-236, 2026 (SCI-Expanded, Scopus, TRDizin) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 2
  • Basım Tarihi: 2026
  • Doi Numarası: 10.5137/1019-5149.jtn.48680-25.2
  • Dergi Adı: Turkish Neurosurgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.229-236
  • Anahtar Kelimeler: Epidural fibrosis, fibroblast proliferation, haemostasis, infliximab, lumbar laminectomy, postoperative adhesion, spinal surgery, TNF-α inhibition, tranexamic acid, wound healing
  • Recep Tayyip Erdoğan Üniversitesi Adresli: Evet

Özet

AIM: To compare 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 Sprague-Dawley rats were randomly assigned into control group (no treatment), TXA treatment group and INF treatment group (n=7 per group). TXA (10–20 mg/mL) and INF (1 mg/mL) were topically applied following L1–L3 laminectomy. Histopathological evaluation involving haematoxylin–eosin and Masson-Goldner’s Trichrome staining was conducted eight weeks postoperatively. EF severity, fibroblast density, inflammatory cell infiltration and neovascularisation were analysed. RESULTS: Histopathological analysis showed that fibrosis scores were significantly lower in the TXA treatment group than in the control and INF treatment groups (p<0.05). Moreover, TXA reduced fibroblast proliferation, inflammatory cell infiltration and collagen deposition. While INF exhibited moderate anti-fibrotic effects, it 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.