The augmentative role of chitosan and platelet-rich fibrin in reducing epidural fibrosis after laminectomy in rats.

BACKGROUND

Epidural fibrosis (EF) is the major complication that develops in the operative region of the spinal vertebrae. This fibrous scar connects the connective tissue around the lateral nerve roots and epidural, resulting in severe pain post-spinal operation and impairment of the nerves' function.

PURPOSE

This study was conducted to investigate the effect of using platelet-rich fibrin (PRF), chitosan, and their combination in reducing epidural fibrosis after laminectomy in rats.

METHODS

Ninety male Sprague Dawley rats weighing 255 ± 55 g were randomly assigned to five groups, each consisting of 15 rats: the normal group (control), the laminectomy group, the PRF group, the chitosan group, the combination group (PRF/chitosan), and the donor group. All rats, except the control group, had lumbar laminectomy surgeries between L3 and L5. Macroscopic analysis, histological evaluations, and mRNA analysis for TGFβ-1 and IL6 were compared statistically after a 30-day follow-up.

RESULTS

In comparison to the laminectomy group, the EF area was significantly decreased in the PRF, chitosan, and combination groups. Histological study, macroscopic inspection, and mRNA expression of TGFβ-1 (P < 0.0001) and IL6 (P < 0.0001) show that the use of PRF with chitosan topically in dura following laminectomy resulted in a decrease in scar tissue formation, inflammation, and EF post-laminectomy.

CONCLUSION

The combination of chitosan with PRF is a potential therapeutic approach for minimizing EF in rats after laminectomy.