title: Investigation of efficacy of mitomycin-C, sodium hyaluronate and human amniotic fluid in preventing epidural fibrosis and adhesion using a rat laminectomy model.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  The aim of this study was to evalute the effects of mitomycin-C, sodium hyaluronate and human amniotic fluid on preventing spinal epidural fibrosis.
  
  
  BACKGROUND
  The role of scar tissue in pain formation is not exactly known, but it is reported that scar tissue causes adhesions between anatomic structures. Intensive fibrotic tissue compresses on anatomic structures and increases the sensitivity of the nerve root for recurrent herniation and lateral spinal stenosis via limiting movements of the root. Also, neuronal atrophy and axonal degeneration occur under scar tissue.
  
  
  METHODS
  The study design included 4 groups of rats: group 1 was the control group, groups 2, 3, and 4 receieved antifibrotic agents, mitomycin-C (group 2), sodium hyaluronate (group 3), and human amniotic fluid (group 4). Midline incision for all animals were done on L5 for total laminectomy. Four weeks after the surgery, the rats were sacrificed and specimens were stained with hematoxylin-eosin and photos of the slides were taken for quantitive assesment of the scar tissue.
  
  
  RESULTS
  There was no significant scar tissue in the experimental animals of groups 2, 3, and 4. It was found that there was no significant difference between drug groups, but there was a statistically significant difference between the drug groups and the control group.
  
  
  CONCLUSIONS
  This experimental study shows that implantation of mitomycin-C, sodium hyaluronate and human amniotic fluid reduces epidural fibrosis and adhesions after spinal laminectomy in rat models. Further studies in humans are needed to determine the complications of the agents researched.
authors.affiliation: Department of Neurosurgery, Neurosurgery Clinic, Dogubeyazıt State Hospital, Agrı, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Bolat
authors.affiliation: Department of Histology and Embryology, Pamukkale University School of Medicine, Denizli, Turkey.
authors.forename: Erdoğan
authors.initials: E
authors.lastname: Kocamaz
authors.affiliation: Department of Neurosurgery, Neurosurgery Clinic, Fatsa Cinar Hospital, Ordu, Turkey.
authors.forename: Zeki
authors.initials: Z
authors.lastname: Kulahcilar
authors.affiliation: Department of Neurosurgery, Neurosurgery Clinic, Dogubeyazıt State Hospital, Agrı, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Yilmaz
authors.affiliation: Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Topcu
authors.affiliation: Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey.
authors.forename: Mevci
authors.initials: M
authors.lastname: Ozdemir
authors.affiliation: Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey.
authors.forename: Mehmet Erdal
authors.initials: ME
authors.lastname: Coskun
keywords: Epidural fibrosis; Lumbar disc herniation; Lumbar pain; Lumbar spinal stenosis; Lumbar spine