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Published on: October 23, 2019
Use of pimecrolimus to prevent epidural fibrosis in a postlaminectomy rat model
Berker Cemil1, Kagan Tun, Erkan Kaptanoglu
1Department of Neurosurgery, Ankara Numune Education and Research Hospital, Ankara, Turkey. berker5@yahoo.com
Object:
Epidural fibrosis is the scar tissue formed over the dura mater after a laminectomy. Extensive epidural fibrosis may be an important underlying cause of failed back syndrome. Pimecrolimus, an ascomycin derivative, is one of the new classes of immunomodulating macrolactams and was specifically developed for the treatment of inflammatory diseases. This study examined the preventive effects of the local application of pimecrolimus in minimizing spinal epidural fibrosis in a rat laminectomy model.
Methods:
Thirty Wistar rats were divided into 3 equal groups: control, mitomycin C (MMC), and pimecrolimus groups. Each rat underwent a laminectomy at the L-3 lumbar level. In the experimental groups, a cotton pad soaked with MMC (0.5 mg/ml) or 5 mg pimecrolimus was placed on the exposed dura mater. No treatment was performed in the control group rats. Thirty days after surgery, the rats were killed and the dura mater thickness, epidural fibrosis, and arachnoidal involvement were quantified.
Results:
The mean dura thickness was measured at 9.28 +/- 3.39 microm in the MMC group and at 8.69 +/- 2.32 microm in the pimecrolimus group, compared with 14.70 +/- 4.14 microm in the control group. In addition, the epidural fibrosis and arachnoidal involvement were reduced significantly in the treatment groups compared with the control group.
Conclusions:
In this animal model, it was shown that locally applied pimecrolimus effectively reduces epidural fibrosis and dural adherence in rats that underwent lumbar laminectomy. Mitomycin C was equally effective as pimecrolimus in reducing epidural fibrosis and dural adherence in this study.
Insights
Local application of pimecrolimus effectively reduces spinal epidural fibrosis after laminectomy in rats. This immunomodulating macrolactam, similar to mitomycin C, shows promise in preventing scar tissue formation and dural adherence.
Area of Science:
- Neurosurgery
- Pharmacology
- Immunology
Background:
- Epidural fibrosis, a scar tissue post-laminectomy, is a significant cause of failed back syndrome.
- Pimecrolimus is an immunomodulating macrolactam developed for inflammatory conditions.
Purpose of the Study:
- To evaluate the preventive efficacy of locally applied pimecrolimus in reducing spinal epidural fibrosis in a rat laminectomy model.
Main Methods:
- Thirty Wistar rats underwent L-3 laminectomy and were divided into control, mitomycin C (MMC), and pimecrolimus groups.
- Experimental groups received a cotton pad soaked with MMC or pimecrolimus on the exposed dura mater.
- Dura mater thickness, epidural fibrosis, and arachnoidal involvement were quantified 30 days post-surgery.
Main Results:
- Pimecrolimus (8.69 ± 2.32 µm) and MMC (9.28 ± 3.39 µm) groups showed significantly reduced dura thickness compared to the control group (14.70 ± 4.14 µm).
- Both treatment groups demonstrated significant reductions in epidural fibrosis and arachnoidal involvement compared to controls.
Conclusions:
- Locally applied pimecrolimus effectively minimizes spinal epidural fibrosis and dural adherence in a rat model post-laminectomy.
- Mitomycin C demonstrated comparable efficacy to pimecrolimus in reducing epidural fibrosis and dural adherence.
