A comparison of the local effectiveness of mitomycin C, aprotinin, and Adcon-L in experimental peridural fibrosis.
BACKGROUND
Peridural fibrosis and leptomeningeal adhesion formation are among the common causes of FBSS. Various materials have been used to prevent the compressive effect of postoperative PF on neural structures. We investigated and compared the effects of 3 agents--aprotinin, mitomycin C, and Adcon-L--to PF after lumbar laminectomy in rabbits.


METHODS
Four groups each including 8 rabbits were formed: Adcon-L, aprotinin, mitomycin C, and control groups. L3 laminectomy was performed on each animal. One of the 3 agents was administered locally to laminectomy areas in each group. All the animals were killed 4 weeks after the surgery. Peridural fibrosis, arachnoidal fibrosis, and dural adhesions were evaluated histologically and graded. The results were compared statistically by using a standard chi2 test.


RESULTS
There were significant differences in the PF grades among the experimental groups and the control group (P < .05). When the fibroblast density and the inflammatory cell density were evaluated, the grades of the experimental groups were better compared with the grades of the control group, but the difference was not statistically significant (P > .05).


CONCLUSIONS
Various materials have been used to prevent the compressive effect of postoperative PF on the neural structures. Aprotinin, mitomycin C, and Adcon-L are effective in preventing PF and dural adhesions in postlaminectomy areas. However, mitomycin C and Adcon-L were more effective than aprotinin in preventing peridural scarring.
Kurt
Gökhan
G
Department of Neurosurgery, Faculty of Medicine, University of Gazi, Ankara 06500, Turkey.
Aytar
Murat Hamit
MH
Doğulu
Fikret
F
Cemil
Berker
B
Erdem
Ozlem
O
Baykaner
M Kemali
MK
Ceviker
Necdet
N
D000818:Animals; D007611:Aprotinin / Q000627:therapeutic use*; D004388:Dura Mater / Q000473:pathology; D004824:Epidural Space / Q000473:pathology*; D005355:Fibrosis; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use; D009930:Organic Chemicals / Q000627:therapeutic use; D011817:Rabbits; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000517:prevention & control
C104199:ADCON-L; D019384:Nucleic Acid Synthesis Inhibitors; D009930:Organic Chemicals; D015842:Serine Proteinase Inhibitors; D016685:Mitomycin; D007611:Aprotinin