ORIGINAL ARTICLE
Comparative Preventive Efficacy of Recombinant
Tissue Plasminogen Activator (rt-PA),
Urokinase, Hyaluronic acid and Enoxaparin
in Post Laminectomy Epidural Fibrosis in
Rats
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Dicle University, School of Medicine, Diyarbakır, Turkey
Publication date: 2011-07-11
Corresponding author
Serdar Kemaloğlu
Faik Ali Sk. Rauf Bey Apt. No:22 Ofis
21100, Diyarbakır, Turkey
Eur J Gen Med 2011;8(3):170-175
KEYWORDS
ABSTRACT
Aim: We aimed to determine the effects of rt-PA and enoxaparin on
post laminectomy epidural fibrosis and to compare the effects of
these two medications with hyaluronic acid and urokinase in an experimental
model of spinal epidural fibrosis.
Method: Forty Spraque-Dawley rats were anaesthetized by intraperitoneal
anesthesia (ketamin 8 mg/100 g) and randomly allocated
to five groups. All groups were underwent L1-2 total laminectomies.
Topical medications were applied to group 2-5 right after the laminectomy
space. Hence, in group 1 (G1=control) only laminectomy was
constituted, in group 2 (G2) laminectomy + topical Urokinase, in group
3 (G3) laminectomy + topical rt-PA, in group 4 (G4) laminectomy +
topical enoxaparin and in group 5 laminectomy + topical Hyaluronic
acid (G5) application were performed. The potentials of local urokinase,
rt-PA, hyaluronic acid and enoxaparin in preventing the production
of epidural fibrosis were assessed.
Result: In inter group comparison, G1-G2, G1-G3, G1-G4, G1-G5
groups differed from each other for total scar score, middle scar
score and deep scar score (p<0.05). However, G2-G3, G2-G4, G2-G5,
G3-G4, G3-G5 and G4-G5 were not different from each other.
Conclusion: In rats, the topical thrombolysis with fibrinolitic agents
is safe and efficacious in preventing of post laminectomy epidural
fibrosis. Thrombolytic therapy with topical hyaluronic acid, rt-PA,
urokinase and enoxaparin may come to play an important role in the
prevention of post operative spinal epidural fibrosis and arachnoiditis.
Based on the results we found that rt-PA and enoxaparine inhibit
the formation of epidural scar adhesions and arachnoiditis compared
with control group.