PDF(Pubmed)
Abstract：
OBJECTIVE: The present study aimed to determine the topical and systemic efficacy of tranexamic acid (TXA) on epidural fibrosis in a rat laminectomy model.
METHODS: Thirty-two 12-month-old adult Sprague-Dawley rats were used in this study. Each rat underwent bilateral laminectomy at the L1 and L2 vertebral levels. Rats were divided into four groups : in group I (control group, n=8), a laminectomy was performed and saline solution was applied into the surgical space. In group II (topical group, n=8), laminectomy was performed and 30 mg/ kg TXA was applied to the surgical site before skin closure. In group III (systemic group, n=8), 30 mg/kg TXA was administered intravenously via the tail vein in the same session as the surgical procedure. In group IV (topical and systemic group, n=8), TXA was administered 30 mg/kg both topical and intravenous. The rats were sacrificed at 4 weeks postoperatively. Masson\'s trichrome and hematoxylin and eosin were used to assess acute inflammatory cells, chronic inflammatory cells, vascular proliferation, and epidural fibrosis.
RESULTS: Epidural fibrosis, acute inflammation, chronic inflammation, and sum histologic score value were significantly lower in the systemic TXA group, systemic and topical TXA groups than in the control group (p<0.05). In addion, the sum histologic score was significantly lower in the topical TXA group than in the control group (p<0.05).
CONCLUSIONS: In this study, epidural fibrosis formation was prevented more by systemic application, but the topical application was found to be effective when compared to the control group. As a result, we recommend the systemic and topical use of TXA to prevent epidural fibrosis during spinal surgery.
METHODS: Thirty-two 12-month-old adult Sprague-Dawley rats were used in this study. Each rat underwent bilateral laminectomy at the L1 and L2 vertebral levels. Rats were divided into four groups : in group I (control group, n=8), a laminectomy was performed and saline solution was applied into the surgical space. In group II (topical group, n=8), laminectomy was performed and 30 mg/ kg TXA was applied to the surgical site before skin closure. In group III (systemic group, n=8), 30 mg/kg TXA was administered intravenously via the tail vein in the same session as the surgical procedure. In group IV (topical and systemic group, n=8), TXA was administered 30 mg/kg both topical and intravenous. The rats were sacrificed at 4 weeks postoperatively. Masson\'s trichrome and hematoxylin and eosin were used to assess acute inflammatory cells, chronic inflammatory cells, vascular proliferation, and epidural fibrosis.
RESULTS: Epidural fibrosis, acute inflammation, chronic inflammation, and sum histologic score value were significantly lower in the systemic TXA group, systemic and topical TXA groups than in the control group (p<0.05). In addion, the sum histologic score was significantly lower in the topical TXA group than in the control group (p<0.05).
CONCLUSIONS: In this study, epidural fibrosis formation was prevented more by systemic application, but the topical application was found to be effective when compared to the control group. As a result, we recommend the systemic and topical use of TXA to prevent epidural fibrosis during spinal surgery.
摘要：
本研究旨在确定氨甲环酸（TXA）对大鼠椎板切除术模型中硬膜外纤维化的局部和全身功效。
■本研究使用32只12月龄成年Sprague-Dawley大鼠。每只大鼠在L1和L2椎骨水平进行双侧椎板切除术。大鼠分为四组:Ⅰ组(对照组,n=8),进行了椎板切除术,并将盐溶液应用于手术空间.在II组中（局部组，n=8),进行椎板切除术，并在皮肤闭合前将30mg/kgTXA应用于手术部位。在组III（系统组，n=8),在与外科手术相同的阶段中通过尾静脉静脉内施用30mg/kgTXA。在IV组中（局部和全身组，n=8),TXA局部和静脉内施用30mg/kg。术后4周处死大鼠。Masson的三色和苏木精和伊红用于评估急性炎症细胞，慢性炎症细胞，血管增生,和硬膜外纤维化。
■硬膜外纤维化，急性炎症，慢性炎症，全身TXA组的组织学评分和总和值显着降低，全身和局部TXA组均优于对照组(p<0.05)。另外，局部TXA组的总组织学评分明显低于对照组（p<0.05）。
■在这项研究中，通过全身应用更多的预防硬膜外纤维化的形成，但与对照组相比，局部应用被发现是有效的。因此,我们建议全身和局部使用TXA来预防脊柱手术中的硬膜外纤维化.
■本研究使用32只12月龄成年Sprague-Dawley大鼠。每只大鼠在L1和L2椎骨水平进行双侧椎板切除术。大鼠分为四组:Ⅰ组(对照组,n=8),进行了椎板切除术,并将盐溶液应用于手术空间.在II组中（局部组，n=8),进行椎板切除术，并在皮肤闭合前将30mg/kgTXA应用于手术部位。在组III（系统组，n=8),在与外科手术相同的阶段中通过尾静脉静脉内施用30mg/kgTXA。在IV组中（局部和全身组，n=8),TXA局部和静脉内施用30mg/kg。术后4周处死大鼠。Masson的三色和苏木精和伊红用于评估急性炎症细胞，慢性炎症细胞，血管增生,和硬膜外纤维化。
■硬膜外纤维化，急性炎症，慢性炎症，全身TXA组的组织学评分和总和值显着降低，全身和局部TXA组均优于对照组(p<0.05)。另外，局部TXA组的总组织学评分明显低于对照组（p<0.05）。
■在这项研究中，通过全身应用更多的预防硬膜外纤维化的形成，但与对照组相比，局部应用被发现是有效的。因此,我们建议全身和局部使用TXA来预防脊柱手术中的硬膜外纤维化.
