Use of pimecrolimus to prevent epidural fibrosis in a postlaminectomy rat model Laboratory investigation
Use of pimecrolimus to prevent epidural fibrosis in a postlaminectomy rat model Laboratory investigation
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DOI：
10.3171/2009.6.spine08580
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发表时间：
2009-12-01
影响因子：
2.8
通讯作者：
Tekdemir, Ibrahim
中科院分区：
文献类型：
--
作者：
Cemil, Berker;Tun, Kagan;Tekdemir, Ibrahim
目的。硬膜外纤维化是椎板切除术后在硬脑膜上形成的疤痕组织。广泛的硬膜外纤维化可能是失败背部综合征的重要根本原因。吡美莫司是一种子囊霉素衍生物，是新型免疫调节大环内酰胺类药物之一，专为治疗炎症性疾病而开发。本研究在大鼠椎板切除模型中检验了局部应用吡美莫司对减少脊髓硬膜外纤维化的预防作用。方法。将 30 只 Wistar 大鼠分为 3 个相等的组：对照组、丝裂霉素 C (MMC) 组和吡美莫司组。每只大鼠均接受 L-3 腰椎水平的椎板切除术。在实验组中，将浸有MMC（0.5mg/ml）或5mg吡美莫司的棉垫放置在暴露的硬脑膜上。对照组大鼠不进行任何治疗。手术后三十天，处死大鼠，并对硬脑膜厚度、硬膜外纤维化和蛛网膜受累进行定量。结果。 MMC组的平均硬脑膜厚度为9.28+/-3.39μm，吡美莫司组的平均硬脑膜厚度为8.69+/-2.32μm，而对照组的平均硬脑膜厚度为14.70+/-4.14μm。此外，与对照组相比，治疗组硬膜外纤维化和蛛网膜受累显着减少。结论。在该动物模型中，结果表明，局部应用吡美莫司可有效减少接受腰椎椎板切除术的大鼠的硬膜外纤维化和硬膜粘附。在这项研究中，丝裂霉素 C 在减少硬膜外纤维化和硬膜粘附方面与吡美莫司同样有效。 （DOI：10.3171/2009.6.SPINE08580）
Object. Epidural fibrosis is the scar tissue formed over the dura mater after a laminectomy. Extensive epidural fibrosis may be an important underlying cause of failed back syndrome. Pimecrolimus, an ascomycin derivative, is one of the new classes of immunomodulating macrolactams and was specifically developed for the treatment of inflammatory diseases. This study examined the preventive effects of the local application of pimecrolimus in minimizing spinal epidural fibrosis in a rat laminectomy model.Methods. Thirty Wistar rats were divided into 3 equal groups: control, mitomycin C (MMC), and pimecrolimus groups. Each rat underwent a laminectomy at the L-3 lumbar level. In the experimental groups, a cotton pad soaked with MMC (0.5 mg/ml) or 5 mg pimecrolimus was placed on the exposed dura mater. No treatment was performed in the control group rats. Thirty days after surgery, the rats were killed and the dura mater thickness, epidural fibrosis, and arachnoidal involvement were quantified.Results. The mean dura thickness was measured at 9.28 +/- 3.39 mu m in the MMC group and at 8.69 +/- 2.32 mu m in the pimecrolimus group, compared with 14.70 +/- 4.14 mu m in the control group. In addition, the epidural fibrosis and arachnoidal involvement were reduced significantly in the treatment groups compared with the control group.Conclusions. In this animal model, it was shown that locally applied pimecrolimus effectively reduces epidural fibrosis and dural adherence in rats that underwent lumbar laminectomy. Mitomycin C was equally effective as pimecrolimus in reducing epidural fibrosis and dural adherence in this study. (DOI: 10.3171/2009.6.SPINE08580)