MMC Controlled-release Membranes Attenuate Epidural Scar Formation in Rat Models After Laminectomy

Overview

Journal Mol Med Rep

Specialty Molecular Biology

Date 2017 May 11

PMID 28487972

Citations 3

Authors

Hao Xie

Binbin Wang

Xun Shen

Jian Qin

Longhai Jiang

Chen Yu

Dawei Geng

Tangbo Yuan

Tao Wu

Xiaojian Cao

Jun Liu

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review.

Lewik G, Lewik G, Muller L, von Glinski A, Schulte T, Lange T Spine Surg Relat Res. 2024; 8(2):133-142.

PMID: 38618214 PMC: 11007250. DOI: 10.22603/ssrr.2023-0106.

The clinical significance and function of miR-146 in the promotion of epidural fibrosis.

Fang Y, Hu X, Liu S, Zou Y, Wang Z, Chu Y Genet Mol Biol. 2021; 44(2):e20200447.

PMID: 33999095 PMC: 8127721. DOI: 10.1590/1678-4685-GMB-2020-0447.

Neutrophil extracellular traps promote scar formation in post-epidural fibrosis.

Jin Z, Sun J, Song Z, Chen K, Nicolas Y, Kc R NPJ Regen Med. 2020; 5(1):19.

PMID: 33298919 PMC: 7599244. DOI: 10.1038/s41536-020-00103-1.

References

Bendebba M, Augustus van Alphen H, Long D . Association between peridural scar and activity-related pain after lumbar discectomy. Neurol Res. 1999; 21 Suppl 1:S37-42. DOI: 10.1080/01616412.1999.11741025. View

Chandler K, Cappello R . Laminectomy membrane formation in dogs: is the answer still elusive?. Vet J. 2005; 172(1):1-2. DOI: 10.1016/j.tvjl.2005.04.011. View

Yang L, Tang J, Chen H, Ge D, Sui T, Que J . Taurine Reduced Epidural Fibrosis in Rat Models after Laminectomy via Downregulating EGR1. Cell Physiol Biochem. 2016; 38(6):2261-71. DOI: 10.1159/000445581. View

Sizer Jr P, Phelps V, Dedrick G, Matthijs O . Differential diagnosis and management of spinal nerve root-related pain. Pain Pract. 2006; 2(2):98-121. DOI: 10.1046/j.1533-2500.2002.02012.x. View

Lee J, Stenzel W, Lohr M, Stutzer H, Ernestus R, Klug N . The role of mitomycin C in reducing recurrence of epidural fibrosis after repeated operation in a laminectomy model in rats. J Neurosurg Spine. 2006; 4(4):329-33. DOI: 10.3171/spi.2006.4.4.329. View

Liu J, Ni B, Zhu L, Yang J, Cao X, Zhou W . Mitomycin C-polyethylene glycol controlled-release film inhibits collagen secretion and induces apoptosis of fibroblasts in the early wound of a postlaminectomy rat model. Spine J. 2010; 10(5):441-7. DOI: 10.1016/j.spinee.2010.02.017. View

Bakaltcheva I, Ganong J, Holtz B, Peat R, Reid T . Effects of high-molecular-weight cryoprotectants on platelets and the coagulation system. Cryobiology. 2000; 40(4):283-93. DOI: 10.1006/cryo.2000.2247. View

Ozgen S, Naderi S, Ozek M, Pamir M . Findings and outcome of revision lumbar disc surgery. J Spinal Disord. 1999; 12(4):287-92. View

Gerszten P, Moossy J, Bahri S, Kalend A, Martinez A . Inhibition of peridural fibrosis after laminectomy using low-dose external beam radiation in a rat model. Neurosurgery. 1999; 44(3):597-602; discussion 602-3. DOI: 10.1097/00006123-199903000-00090. View

10.

Pospiech J, Pajonk F, Stolke D . Epidural scar tissue formation after spinal surgery: an experimental study. Eur Spine J. 1995; 4(4):213-9. DOI: 10.1007/BF00303413. View

11.

Dogulu F, Kurt G, Emmez H, Erdem O, Memis L, Baykaner K . Topical mitomycin C-induced inhibition of postlaminectomy peridural fibrosis in rabbits. J Neurosurg. 2003; 99(1 Suppl):76-9. DOI: 10.3171/spi.2003.99.1.0076. View

12.

Sun Y, Wang L, Wang L, Sun S, Cao X, Wang P . A comparison of the effectiveness of mitomycin C and 5-fluorouracil in the prevention of peridural adhesion after laminectomy. J Neurosurg Spine. 2007; 7(4):423-8. DOI: 10.3171/SPI-07/10/423. View

13.

Tao H, Fan H . Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions. Eur Spine J. 2009; 18(8):1202-12. PMC: 2899499. DOI: 10.1007/s00586-009-1013-x. View

14.

Temel S, Ozturk C, Temiz A, Ersozlu S, Aydinli U . A new material for prevention of epidural fibrosis after laminectomy: oxidized regenerated cellulose (interceed), an absorbable barrier. J Spinal Disord Tech. 2006; 19(4):270-5. DOI: 10.1097/01.bsd.0000203946.11546.d9. View

15.

Costa R, Pippi N, Graca D, Fialho S, Alves A, Groff A . The effects of free fat graft or cellulose membrane implants on laminectomy membrane formation in dogs. Vet J. 2006; 171(3):491-9. DOI: 10.1016/j.tvjl.2004.12.011. View

16.

Welch W, Cornwall G, Toth J, Turner A, Thomas K, Gerszten P . Use of polylactide resorbable film as an adhesion barrier. Orthopedics. 2002; 25(10 Suppl):s1121-30. DOI: 10.3928/0147-7447-20021002-02. View

17.

Vogelsang J, Finkenstaedt M, Vogelsang M, Markakis E . Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRI. Eur Spine J. 2000; 8(6):475-9. PMC: 3611211. DOI: 10.1007/s005860050208. View

18.

Bartynski W, Petropoulou K . The MR imaging features and clinical correlates in low back pain-related syndromes. Magn Reson Imaging Clin N Am. 2007; 15(2):137-54, v. DOI: 10.1016/j.mric.2007.01.010. View

19.

Sen O, Kizilkilic O, Aydin M, Yalcin O, Erdogan B, Cekinmez M . The role of closed-suction drainage in preventing epidural fibrosis and its correlation with a new grading system of epidural fibrosis on the basis of MRI. Eur Spine J. 2004; 14(4):409-14. PMC: 3489202. DOI: 10.1007/s00586-004-0801-6. View

20.

Fujii H, Fujii S, Togashi H, Yoshioka M, Nakai K, Satoh H . Attenuation of hypothermia-induced platelet activation and platelet adhesion to artificial surfaces in vitro by modification of hemoglobin to carry S-nitric oxide and polyethylene glycol. Thromb Res. 2001; 100(6):519-28. DOI: 10.1016/s0049-3848(00)00364-9. View