Materials and Methods: Twenty-six adult male New Zealand White rabbits were randomly assigned to either a control group (saline) or a treatment group (topical TXA). Each rabbit underwent a two-level laminectomy at the L3-L4 vertebrae. The treatment group received 5 ml of 100 mg/mL TXA solution topically at the laminectomy site, while the control group received 5 ml of saline. At postoperative week 6, macroscopic adhesion assessment and histopathological analysis were performed to quantify inflammatory cells, vessel density, and collagen concentration in scar tissue at the laminectomy site. Additionally, TGF-β and VEGF expression were evaluated in IHC-stained sections.

Results: Macroscopic evaluation showed significantly reduced adhesion in the TXA-treated group compared to the control. Histopathological analysis revealed lower collagen concentration and TGF-β expression in the TXA group, while inflammatory cell count, vessel density, and VEGF expression showed no significant differences between groups.

Conclusions: These findings provide evidence of the efficacy of topical TXA in preventing EF in a rabbit model of spinal surgery. The topical use of TXA appears to be a promising therapeutic strategy for preventing EF and warrants further investigation to evaluate its effectiveness and potential clinical applications.