title: Is topical tissue plasminogen activator application effective on prevention of post-laminectomy epidural fibrosis? An experimental study.
abstract: OBJECTIVE
  Impaired fibrinolytic activity has been shown to be associated with poor outcome after lumbar disc surgery. The purpose of this study was to determine the efficacy of topical tissue plasminogen activator (t-PA) in preventing epidural fibrosis in rats.
  
  
  METHODS
  L4-L5 laminectomy was performed under surgical microscope in 40 rats. Animals received either normal saline (control; n=20) or 0.5 mg/kg t-PA (n=20), topically to the operative sites. All animals were killed 1, 2, 4 and 6 weeks after surgery. Fibrosis, inflammation, necrosis and abscess formation were evaluated histopathologically.
  
  
  RESULTS
  The results showed that 6 weeks after surgery, inhibition in formation of epidural fibrosis was noted in both control and treatment animals. We found no significant differences in inflammation, tissue necrosis and abscess formation between groups.
  
  
  CONCLUSIONS
  A meticulous microsurgical technique with careful hemostasis seems to be an effective and adequate method for prevention of epidural fibrosis.
authors.affiliation: Department of Neurosurgery, Baskent University, Faculty of Medicine, Ankara, Turkey. melihcekinmez@yahoo.com
authors.forename: Melih
authors.initials: M
authors.lastname: Cekinmez
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.forename: Kadir
authors.initials: K
authors.lastname: Tufan
authors.forename: Feyzi B
authors.initials: FB
authors.lastname: Sarica
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ozen
authors.forename: Hakan
authors.initials: H
authors.lastname: Caner
mesh_terms: D000287:Administration, Topical; D000818:Animals; D002921:Cicatrix / Q000517:prevention & control*; D004353:Drug Evaluation, Preclinical; D004388:Dura Mater / Q000473:pathology; D005355:Fibrosis / Q000517:prevention & control; D007796:Laminectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D010959:Tissue Plasminogen Activator