Gürer Bora, Kahveci Ramazan, Gökçe Emre Cemal, Ozevren Huseyin, Turkoglu Erhan, Gökçe Aysun
Department of Neurosurgery, Ministry of Health, Fatih Sultan Mehmet Education and Research Hospital, 34752, Ataşehir, Istanbul, Turkey.
Department of Neurosurgery, Ministry of Health, Kirikkale Yüksek Ihtisas Hospital, Baglarbasi mh. Lokman Hekim cd., Kirikkale, Turkey.
Spine J. 2015 Mar 1;15(3):522-9. doi: 10.1016/j.spinee.2014.10.018. Epub 2014 Oct 22.
Epidural fibrosis is a major challenge in spine surgery, with some patients having recurrent symptoms secondary to excessive formation of scar tissue resulting in neurologic compression. One of the most important factors initiating the epidural fibrosis is assumed to be the transforming growth factor-1β (TGF-1β). Rosuvastatin (ROS) has shown to demonstrate preventive effects over fibrosis via inhibiting the TGF-1β.
We hypothesized that ROS might have preventive effects over epidural fibrosis through the inhibition of TGF-1β pathways.
Experimental animal study.
Forty-eight adult male Wistar Albino rats were equally and randomly divided into four groups (laminectomy, spongostan, topical ROS, and systemic ROS). Laminectomy was performed at the L3 level in all rats. Four weeks later, the extent of epidural fibrosis was assessed both macroscopically and histopathologically.
Our data revealed that topical application and systemic administration of ROS both were effective in reducing epidural fibrosis formation. Furthermore, the systemic administration of ROS yielded better results than topical application.
Both topical application and systemic administration of ROS show meaningful preventive effects over epidural fibrosis through multiple mechanisms. The results of our study provide the first experimental evidence of the preventive effects of ROS over epidural fibrosis.
硬膜外纤维化是脊柱手术中的一项重大挑战,一些患者因瘢痕组织过度形成导致神经受压而出现复发症状。启动硬膜外纤维化的最重要因素之一被认为是转化生长因子-1β(TGF-1β)。瑞舒伐他汀(ROS)已显示出通过抑制TGF-1β对纤维化具有预防作用。
我们假设ROS可能通过抑制TGF-1β途径对硬膜外纤维化具有预防作用。
实验动物研究。
将48只成年雄性Wistar白化大鼠平均随机分为四组(椎板切除术组、明胶海绵组、局部ROS组和全身ROS组)。所有大鼠均在L3水平进行椎板切除术。四周后,从宏观和组织病理学上评估硬膜外纤维化的程度。
我们的数据显示,局部应用和全身给予ROS均能有效减少硬膜外纤维化的形成。此外,全身给予ROS比局部应用产生更好的效果。
局部应用和全身给予ROS均通过多种机制对硬膜外纤维化显示出有意义的预防作用。我们的研究结果提供了ROS对硬膜外纤维化预防作用的首个实验证据。