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The effect of ankaferd blood stopper on epidural fibrosis after laminectomy in rats: an experimental study

2015; Turkish Neurosurgical Society; Linguagem: Inglês

10.5137/1019-5149.jtn.14559-15.1

2651-5032

Murat Yılmaz, Deniz Gülabi, Bülent Güçlü, İbrahim Kaya, Kayhan Başak, Ali Baş,

Pain Management and Opioid Use

extensive peridural fibrosis and increased low back pain and/ or recurrent radicular pain has been reported (22,27), and the presence of peridural fibrosis has been described in up to 24% of patients with failed back surgery syndrome (5).Since scar excision surgery generally yields poor results, many authors have suggested that prevention of postoperative adhesions is an essential goal in low back surgery.Some anti-neoplastic agents such as mitomycin C, 5-fluorouracil, cyclosporin and some high molecular weight molecules such as hyaluronan, oxidized regenerated cellulose, █ INTRODUCTION L umbar epidural fibrosis is increasingly recognized as a cause of persistent back pain (6).The reported incidence of postoperative epidural fibrosis ranges from 10% to 75% (28).Postlaminectomy epidural fibrosis is a well-known complication of spinal surgery, first mentioned in 1948 (18).Epidural fibrosis (EF) is a pathological process in which normal epidural fat is replaced by scar tissue (21).The epidural space is irregularly filled with scar tissue that can compress or retract the dural sac and/or nerve roots.A relationship between AIm: Lumbar epidural fibrosis is increasingly recognized as a cause of persistent back pain.The aim of this study was to examine the effect Ankaferd Blood Stopper on epidural fibrosis following laminectomy in rat models.mATERIAl and mEThODS: Twenty Sprague-Dawley male rats were randomly allocated to 2 groups of 10 each.The dura mater and nerve root were exposed after L1 unilateral laminectomy.Close attention was paid not to traumatize the dura, the nerve roots, or the dissected muscles.Immediate muscle and skin closure was made in sham group.In the Ankaferd Blood Stopper group, cotton wool soaked with 1 mL Ankaferd Blood Stopper was applied to the exposure site for 5 minutes, and muscle and skin closure was then made.Histological analysis was performed at four weeks postoperatively. RESUlTS:Epidural fibrosis formation evaluation and fibroblastic activity evaluation revealed that there was a significant difference between the sham and the Ankaferd Blood Stopper treated groups (p = 0.011, p = 0.009).Severe epidural adhesions were observed in the Ankaferd Blood Stopper group.Dissection of these epidural adhesions was difficult and accompanied by bleeding and disruption of the dura mater. CONClUSION:The results of this study showed that there was no positive effect of Ankaferd Blood Stopper on the prevention of epidural fibrosis, which is one of the most significant problems following spinal surgery, and the epidural fibrosis actually increased.