Effect of cepea extract-heparin and allantoin mixture on epidural fibrosis in a rat hemilaminectomy model.
OBJECTIVE
Epidural fibrosis following a laminectomy procedure is a serious problem that results in failed back surgery syndrome. Aserious number of manuscripts have explained its possible mechanism and results but no effective preventive surgical technique or treatment is currently present.


METHODS
We used a rat hemilaminectomy model at lumbar fourth level. In the treatment group (n:10), the hemilaminectomy sites were filled with cepea extract-allantoin and heparin mixture as sterile cream form. In the second group, the same surgical procedure was performed and the site was filled with physiological saline. All animals were terminated after 6 weeks and laminectomy sites removed en-bloc. Epidural fibrosis was evaluated and compared using semi-quantitative histopathological scoring scales.


RESULTS
In the physiological saline group, the fibrosis score was 10.3 points and 90% of the subjects had acute inflammatory reaction, 80% chronic inflammatory reaction and 100% showed bone destruction and reparation process. In the cepea extract group, these values were fibrosis score 4.2 points, 0% acute inflammatory reaction, 33.3% chronic inflammatory reaction and 10% bone destruction and reparation process, respectively.


CONCLUSIONS
This study showed that aloe cepea extract-allantoin and heparin mixture diminished epidural scarring formation effectively with decreased scores of acute and chronic inflammation, compared to the physiological saline solution group.
Celal Bayar University School of Medicine, Neurosurgery Department, Manisa, Turkey. temiz2@tr.net
Cuneyt
C
Temiz
Peyker
P
Temiz
Murat
M
Sayin
Kubilay
K
Ucar
D000481:Allantoin / Q000494:pharmacology*; D000504:Aloe; D000818:Animals; D004195:Disease Models, Animal; D004338:Drug Combinations; D004487:Edema / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control; D004824:Epidural Space / Q000473:pathology; D055111:Failed Back Surgery Syndrome / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control*; D005343:Fibrinolytic Agents / Q000494:pharmacology; D005355:Fibrosis; D006493:Heparin / Q000494:pharmacology*; D007796:Laminectomy; D008159:Lumbar Vertebrae; D008297:Male; D010627:Phenethylamines / Q000494:pharmacology*; D010936:Plant Extracts / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology / Q000601:surgery
D004338:Drug Combinations; D005343:Fibrinolytic Agents; D010627:Phenethylamines; D010936:Plant Extracts; C054163:N-(2-cyanoethyl)-2-phenylethylamine; D000481:Allantoin; D006493:Heparin