Sıçanlarda laminektomi sonrası epidural fibrozis oluşumunda ooferektominin etkisi: Deneysel çalışma

Year 2013, Volume: 47 Issue: 3, 193 - 200, 11.06.2013

Esra Circi Metin Ozalay Berrin Caylak Didem Bacanli Alihan Derincek İ. Cengiz Tuncay

Abstract

Amaç: Bu çalışmanın amacı sıçanlarda laminektomi uygulaması sonrası epidural fibrozis oluşumunda ooferektominin etkisini araştırmak idi.
Çalışma planı: Bu çalışmada 36 adet 12 aylık erişkin dişi Sprague-Dawley cinsi sıçan kullanıldı. Sıçanlar iki gruba ayrıldı; ooferektomi uygulanan ve ooferektomi uygulanmayan grup. Ooferektomi uygulanan gruptaki 18 sıçana bilateral, ooferektomi sonrası 3. haftada her iki gruptaki sıçanların tamamına L2 ve L3 lomber vertebralara bilateral komplet laminektomi uygulandı. Sıçanlar rastgele 3 eşit gruba ayrıldı. Sıçanlar laminektomi sonrası 4., 8. ve 12. haftalarda sakrifiye edildi. Lomber vertebraları blok şeklinde çıkarıldı, tespit ve dekalsifiye edildi. Kesitler hematoksilen ve eozin ve Masson trikrom ile boyandı ve epidural fibrozis, akut enflamasyon, kronik enflamasyon ve vasküler proliferasyon yönünden değerlendirildi.
Bulgular: Epidural fibrozis ortalama histolojik toplamı ooferektomi uygulanan grupta daha fazla idi (p>0.05).
Çıkarımlar: Endojen östrojenin sıçanlarda lomber laminektomi sonrası epidural fibrozis oluşumuna etkili olabileceği anlaşılmaktadır.

Keywords

Epidural fibrozis; histolojik değerlendirme; laminektomi; östrojen; sıçan.

The effect of oophorectomy on epidural fibrosis after laminectomy: an experimental study in rats

Abstract

Objective: The aim of this study was to examine the effect of oophorectomy in the formation of epidural fibrosis in a rat laminectomy model.
Methods: Thirty-six 12-month-old adult female Sprague-Dawley rats were used in this study. Rats were evenly divided into two groups; oophorectomized and sham-operated. Bilateral oophorectomy was performed on the 18 rats in the oophorectomized group. Three weeks after oophorectomy, rats in both groups underwent complete bilateral laminectomy at the L2 and L3 vertebral levels. Rats were divided into 3 equal groups and sacrificed in groups of 4 at the 4th, 8t, and 12th weeks postoperatively and the lumbar spine excised en bloc, fixed and decalcified. Sections were stained with hematoxylin and eosin and Masson’s trichrome were used to evaluate epidural fibrosis, acute inflammation, chronic inflammation, and vascular proliferation.
Results: The mean histological sum grade of the epidural fibrosis was greater in the oophorectomized group (p>0.05).
Conclusion: Endogenous estrogen could have an effect on epidural fibrosis formation after lumbar laminectomy in rats.

Keywords

Epidural fibrosis, histological comparison, laminectomy, estrogen, rat

References

• Sen O, Kizilkilic O, Aydin MV, Yalcin O, Erdogan B, Cekinmez M, et al. 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 2005;14:409-14.
• Robertson, JT. Role of peridural fibrosis in the failed back: a review. Eur Spine J 1996;5 Suppl 1:S2-6.
• Ross JS, Robertson JT, Frederickson RC, Petrie JL, Obuchowski N, Modic MT, et al. Association between peridural scar and recurrent radicular pain after lumbar dis- cectomy: magnetic resonance evaluation. ADCON-L European Study Group. Neurosurgery 1996;38:855-63.
• Burton CV, Kirkaldy-Willis WH, Yong-Hing K, Heithoff KB. Causes of failure of surgery on the lumbar spine. Clin Orthop Relat Res 1981;(157):191-9.
• Coskun E, Suzer T, Topuz O, Zencir M, Pakdemirli E, and Tahta K. Relationships between epidural fibrosis, pain, dis- ability, and psychological factors after lumbar disc surgery. Eur Spine J 2000;9:218-23.
• Fritsch EW, Heisel J, Rupp S. The failed back surgery syn- drome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments. Spine (Phila Pa 1976) 1996;21:626-33.
• Mohsenipour I, Daniaux M, Aichner F, Twerdy K. Prevention of local scar formation after operative discectomy for lumbar disc herniation. Acta Neurochir (Wien) 1998;140: 9-13.
• Wentorf FA, Sudoh K, Moses C, Arendt EA, Carlson CS. The effects of estrogen on material and mechanical proper- ties of the intra- and extra-articular knee structures. Am J Sports Med 2006;34:1948-52.
• Liu SH, Al-Shaikh RA, Panossian V, Finerman GA, Lane JM. Estrogen affects the cellular metabolism of the anterior cruciate ligament. A potential explanation for female athlet- ic injury. Am J Sports Med 1997;25:704-9.
• Yu WD, Panossian V, Hatch JD, Liu SH, Finerman GA. Combined effects of estrogen and progesterone on the ante- rior cruciate ligament. Clin Orthop Relat Res 2001;(383):268-81.
• Circi E, Akpinar S, Balcik C, Bacanli D, Guven G, Akgun RC, et al. Biomechanical and histological comparison of the influence of oestrogen deficient state on tendon healing potential in rats. Int Orthop 2009;33:1461-6.
• Hart DA, Kydd A, Reno C. Gender and pregnancy affect neuropeptide responses of the rabbit Achilles tendon. Clin Orthop Relat Res 1999;(365):237-46.
• He Y, Revel M, Loty B. A quantitative model of post- laminectomy scar formation. Effects of a nonsteroidal anti- inflammatory drug. Spine (Phila Pa 1976) 1995;20:557-63; discussion 579-80.
• Cooper RG, Mitchell WS, Illingworth KJ, Forbes WS, Gillespie JE, Jayson MI. The role of epidural fibrosis and defective fibrinolysis in the persistence of postlaminectomy back pain. Spine (Phila Pa 1976) 1991;16:1044-8.
• Geisler FH. Prevention of peridural fibrosis: current methodologies. Neurol Res 1999;21 Suppl 1:S9-22.
• Key JA, Ford LT. Experimental intervertebral-disc lesions. J Bone Joint Surg Am 1948;30A:621-30.
• Minamide A, Tamaki T, Hashizume H, Yoshida M, Kawakami M, Hayashi N. Effects of steroid and lipopolysac- charide on spontaneous resorption of herniated interverte- bral discs. An experimental study in the rabbit. Spine (Phila Pa 1976) 1998;23:870-6.
• LaRocca H, Macnab I. The laminectomy membrane. Studies in its evolution, characteristics, effects and prophylaxis in dogs. J Bone Joint Surg Br 1974;56B:545-50.
• Ross JS, Obuchowski N, Zepp R. The postoperative lumbar spine: evaluation of epidural scar over a 1-year period. AJNR Am J Neuroradiol 1998;19:183-6.
• Ronnberg K, Lind B, Zoega B, Gadeholt-Göthlin G, Halldin K, Gellerstedt M, et al. Peridural scar and its rela- tion to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients. Eur Spine J 2008;17:1714-20.
• Cekinmez M, Erdogan B, Tufan K, Sarica FB, Ozen O, Caner H. Is topical tissue plasminogen activator application effective on prevention of post-laminectomy epidural fibro- sis? An experimental study. Neurol Res 2009;31:322-6.
• Lee CK, Alexander H. Prevention of postlaminectomy scar formation. Spine (Phila Pa 1976) 1984;9:305-12.
• Nussbaum CE, McDonald JV, Baggs RB. Use of Vicryl (polyglactin 910) mesh to limit epidural scar formation after laminectomy Neurosurgery 1990;26:649-54.
• Sen O, Gokcel A, Kizilkilic O, Erdogan B, Aydin MV, Sezgin N, et al. The relation between serum levels of osteo- protegerin and postoperative epidural fibrosis in patients who underwent surgery for lumbar disc herniation. Neurol Res 2005;27:452-5.
• Bryant MS, Bremer AM, Nguyen TQ. Autogeneic fat trans- plants in the epidural space in routine lumbar spine surgery. Neurosurgery 1983;13:367-70.
• Jacobs RR, McClain O, Neff J. Control of postlaminectomy scar formation: an experimental and clinical study. Spine (Phila Pa 1976) 1980;5:223-9.
• Magnusson SP, Hansen M, Langberg H, Miller B, Haraldsson B, Westh EK, et al. The adaptability of tendon to loading differs in men and women. Int J Exp Pathol 2007;88:237-40.
• Hinton JL Jr, Warejcka DJ, Mei Y, McLendon RE, Laurencin C, Lucas PA, et al. Inhibition of epidural scar for- mation after lumbar laminectomy in the rat. Spine 1995;20:564-70; discussion 579-80.
• Seneviratne A, Attia E, Williams RJ, Rodeo SA, Hannafin JA. The effect of estrogen on ovine anterior cruciate liga- ment fibroblasts: cell proliferation and collagen synthesis. Am J Sports Med 2004;32:1613-8.