Xie Hao, Wang Binbin, Shen Xun, Qin Jian, Jiang Longhai, Yu Chen, Geng Dawei, Yuan Tangbo, Wu Tao, Cao Xiaojian, Liu Jun
Department of Orthopaedics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
Department of Orthopaedics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
Mol Med Rep. 2017 Jun;15(6):4162-4168. doi: 10.3892/mmr.2017.6531. Epub 2017 Apr 28.
Epidural scar formation after laminectomy impede surgical outcomes of decompression. Mitomycin C (MMC) has been demonstrated to have significant inhibitory effects on epidural scar. This study was undertaken to develop an effective MMC controlled‑release membrane and to investigate its effects on epidural scar in rat models of laminectomy. A total of 72 rats that underwent laminectomy were divided into three groups. Among them, 24 were treated with mitomycin C‑polylactic acid (MMC-PLA) controlled‑release membrane, 24 with mitomycin C-polyethylene glycol (MMC-PEG) controlled-release membrane, and no treatment was performed for the remaining 24 rats (control group). In the following 4 weeks, magnetic resonance image (MRI), macroscopic observation, histology and hydroxyproline (Hyp) concentration analysis were performed to explore the effects of these three therapies on epidural scar. MRI revealed a significant reduction of epidural fibrosis in MMC-PLA and MMC-PEG treatment groups, compared with the control group. Histological results also showed that collagen deposition was significantly reduced after being treated with MMC-PLA or MMC-PEG membranes. Likewise, Hyp concentrations of the epidural scar tissue in MMC-PLA and MMC-PEG groups were markedly lower than those in the control group. However, regarding the effects on reducing epidural scar, no significant difference was found between the MMC-PLA and MMC-PEG groups. In conclusion, MMC-PLA and MMC-PEG membranes are safe and effective in reducing fibrosis. Thus, MMC-controlled-release membranes promises to be a potential therapeutic in preventing epidural scar formation after laminectomy.
椎板切除术后硬膜外瘢痕形成会影响减压手术的效果。丝裂霉素C（MMC）已被证明对硬膜外瘢痕有显著的抑制作用。本研究旨在开发一种有效的MMC控释膜，并研究其在椎板切除大鼠模型中对硬膜外瘢痕的影响。总共72只接受椎板切除术的大鼠被分为三组。其中，24只大鼠用丝裂霉素C-聚乳酸（MMC-PLA）控释膜治疗，24只用丝裂霉素C-聚乙二醇（MMC-PEG）控释膜治疗，其余24只大鼠不进行治疗（对照组）。在接下来的4周内，进行磁共振成像（MRI）、大体观察、组织学和羟脯氨酸（Hyp）浓度分析，以探讨这三种治疗方法对硬膜外瘢痕的影响。MRI显示，与对照组相比，MMC-PLA和MMC-PEG治疗组的硬膜外纤维化明显减少。组织学结果还显示，用MMC-PLA或MMC-PEG膜治疗后，胶原沉积明显减少。同样，MMC-PLA和MMC-PEG组硬膜外瘢痕组织的Hyp浓度明显低于对照组。然而，关于减少硬膜外瘢痕的效果，MMC-PLA组和MMC-PEG组之间没有发现显著差异。总之，MMC-PLA和MMC-PEG膜在减少纤维化方面是安全有效的。因此，MMC控释膜有望成为预防椎板切除术后硬膜外瘢痕形成的一种潜在治疗方法。
