Asian Spine J.  2013 Dec;7(4):253-259. 10.4184/asj.2013.7.4.253.

Investigation of Efficacy of Mitomycin-C, Sodium Hyaluronate and Human Amniotic Fluid in Preventing Epidural Fibrosis and Adhesion Using a Rat Laminectomy Model

• Bolat E
• Kocamaz E
• Kulahcilar Z
• Yilmaz A
• Topcu A
• Ozdemir M
• Coskun ME

• KMID: 2270402
• DOI: http://doi.org/10.4184/asj.2013.7.4.253

Abstract

STUDY DESIGN: A retrospective study. PURPOSE: The aim of this study was to evalute the effects of mitomycin-C, sodium hyaluronate and human amniotic fluid on preventing spinal epidural fibrosis. OVERVIEW OF LITERATURE: The role of scar tissue in pain formation is not exactly known, but it is reported that scar tissue causes adhesions between anatomic structures. Intensive fibrotic tissue compresses on anatomic structures and increases the sensitivity of the nerve root for recurrent herniation and lateral spinal stenosis via limiting movements of the root. Also, neuronal atrophy and axonal degeneration occur under scar tissue.
METHODS
The study design included 4 groups of rats: group 1 was the control group, groups 2, 3, and 4 receieved antifibrotic agents, mitomycin-C (group 2), sodium hyaluronate (group 3), and human amniotic fluid (group 4). Midline incision for all animals were done on L5 for total laminectomy. Four weeks after the surgery, the rats were sacrificed and specimens were stained with hematoxylin-eosin and photos of the slides were taken for quantitive assesment of the scar tissue.
RESULTS
There was no significant scar tissue in the experimental animals of groups 2, 3, and 4. It was found that there was no significant difference between drug groups, but there was a statistically significant difference between the drug groups and the control group.
CONCLUSIONS
This experimental study shows that implantation of mitomycin-C, sodium hyaluronate and human amniotic fluid reduces epidural fibrosis and adhesions after spinal laminectomy in rat models. Further studies in humans are needed to determine the complications of the agents researched.

Keyword

Lumbar spine; Lumbar disc herniation; Lumbar spinal stenosis; Lumbar pain; Epidural fibrosis

MeSH Terms

Amniotic Fluid*
Animals
Atrophy
Axons
Cicatrix
Equidae
Female
Fibrosis*
Humans*
Hyaluronic Acid*
Laminectomy*
Mitomycin*
Models, Animal
Neurons
Rats*
Retrospective Studies
Sodium*
Spinal Stenosis
Hyaluronic Acid
Mitomycin
Sodium