Preventing peridural fibrosis with nonsteroidal anti-inflammatory drugs.
Peridural fibrosis is one of the more frequent complications of lumbar surgery. Nonsteroidal anti-inflammatory drugs inhibit the inflammatory and fibroblastic response. We performed lumbar laminectomies in 24 rabbits, divided into two groups. The experimental group received 5 mg/kg/day of aceclofenac for 7 days and the control group received 1 cm(3) of physiological saline. The samples were stained using immunohistochemical methods. The cellular populations in the inflammatory reaction and the thickness of the fibrous membrane were quantified. The mean of the fibrous area was always less in the rabbits of the experimental group compared to controls (47% less at 2 weeks and 41% less at 4 weeks). We observed an 8% decrease in the number of fibroblasts with antivimentin monoclonal antibodies in the experimental group. In this model, aceclofenac inhibits the presence of inflammatory cells in the fibrous scar in the early stages and reduces the extension of adhesions without adverse reactions.
Sandoval
Manuel A
MA
Hospital San Agustín, Avilés, Asturias, Spain. sandovalmag@yahoo.es.|, C/ Cabruñana, 48-1 A, 33400, Avilés, Spain. sandovalmag@yahoo.es.
Hernandez-Vaquero
Daniel
D
School of Medicine, University of Oviedo, Oviedo, Spain.
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D002921:Cicatrix / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control; D003238:Connective Tissue / Q000187:drug effects / Q000473:pathology; D004008:Diclofenac / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D004195:Disease Models, Animal; D004388:Dura Mater / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D004824:Epidural Space / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D005347:Fibroblasts / Q000187:drug effects / Q000473:pathology; D005355:Fibrosis / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D007249:Inflammation / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000187:drug effects* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D011817:Rabbits; D013115:Spinal Canal / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D000267:Tissue Adhesions / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; C056498:aceclofenac