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Potential risk of mitomycin C at high concentrations on peripheral nerve structure
Tao Sui1, Jinhong Zhang2, Shihao Du1
1Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Abstract:
Although the local application of mitomycin C may prevent epidural adhesion after laminectomy, mitomycin C can induce neurotoxicity in optic and acoustic nerves at high concentrations. To determine the safe concentration range for mitomycin C, cotton pads soaked with mitomycin C at different concentrations (0.1, 0.3, 0.5, and 0.7 mg/mL) were immediately applied for 5 minutes to the operation area of rats that had undergone laminectomy at L1. Rat sciatic nerves, instead of dorsal nerves, were used in this study. The results showed that mitomycin C at 0.1-0.5 mg/mL did not damage the structure and function of the sciatic nerve, while at 0.7 mg/mL, mitomycin C significantly reduced the thickness of the sciatic nerve myelin sheath compared with lower concentrations, though no functional change was found. These experimental findings indicate that the local application of mitomycin C at low concentrations is safe to prevent scar adhesion following laminectomy, but that mitomycin C at high concentrations (> 0.7 mg/mL) has potential safety risks to peripheral nerve structures.
Insights
Local application of mitomycin C (MMC) can prevent epidural adhesion after laminectomy. Studies show low MMC concentrations (0.1-0.5 mg/mL) are safe for peripheral nerves, but higher concentrations may pose risks.
Area of Science:
- Neurosurgery
- Pharmacology
- Biomaterials
Background:
- Epidural adhesion is a common complication after laminectomy, potentially leading to neurological deficits.
- Mitomycin C (MMC) is explored for preventing adhesions, but its neurotoxicity at high concentrations is a concern.
Purpose of the Study:
- To determine the safe concentration range of locally applied mitomycin C (MMC) for preventing epidural adhesion post-laminectomy.
- To evaluate the impact of varying MMC concentrations on peripheral nerve structure and function in a rat model.
Main Methods:
- Rats underwent laminectomy at L1.
- Cotton pads soaked with MMC at concentrations of 0.1, 0.3, 0.5, and 0.7 mg/mL were applied locally for 5 minutes.
- Sciatic nerve structure and function were assessed.
Main Results:
- MMC at concentrations of 0.1-0.5 mg/mL showed no adverse effects on sciatic nerve structure or function.
- A concentration of 0.7 mg/mL significantly reduced sciatic nerve myelin sheath thickness but did not cause functional impairment.
- Higher concentrations (> 0.7 mg/mL) suggest potential risks to peripheral nerve integrity.
Conclusions:
- Low concentrations of locally applied mitomycin C (0.1-0.5 mg/mL) appear safe for preventing scar adhesion following laminectomy.
- Higher concentrations of mitomycin C may present safety risks to peripheral nerve structures, necessitating careful dose selection.
