Postlaminectomy Adhesion of the Cauda Equina in Rats : A Pathophysiological Study for its Prevention

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Purpose. Laminectomy-induced cauda equina adhesion has been proved by rat experiments and postoperative serial magnetic resonance imagings in men. In rats, correlation between cauda equina adhesion and clinical symptoms were analyzed. In addition, the preventive measures for lumbar adhesive arachnoiditis were evaluated.Methods. Wistar rats laminectomized from L5 to L6 were serially assessed for sensory, motor and urinary functions. For the prevention of cauda equina adhesion, rats were divided into 3 groups : Rats in the control group received only vehicle solutions, those in the indomethacin group orally received indomethacin for 7 days, and those in the steroid group were intraperitoneally administered methylprednisolone for 3 days. At 24 hours, 3 and 6 weeks after laminectomy, the cauda equina adhesion and leakage of a protein tracer from the nutrient vessels were histologically compared in the 3 groups.Results. Threshold for thermal stimulation assessed by tail flick test showed elongation in rats with cauda equina adhesion. Other symptoms revealed no significant changes after laminectomy with or without kaolin implementation. Both indomethacin and methylprednisolone significantly suppressed cauda equina adhesion and protein leakage from the nutrient vessels at 24 hours after laminectomy. Rats treated with the anti-inflammatory drugs showed diminution of cauda equina adhesion and the neural degeneration at 3 and 6 weeks after laminectomy.Conclusion. Cauda equina adhesion after laminectomy brought about thermal hypesthesia in rats. Anti-inflammatory drug administration before and after laminectomy suppressed cauda equina adhesion, and facilitated the recovery of cauda equina adhesion.