Less Use of the Bipolar Cautery can Prevent Postlaminectomy Epidural Fibrosis: An Experimental Study in Rats

Özet

AIM: To investigate the role of bipolar electrocautery in the occurrence of epidural fibrosis following lumbar spine laminectomy ina rat model.MATERIAL and METHODS: Fourteen male Sprague–Dawley rats (age: 4–6 months, weight: 250–300 g) were randomly dividedinto two groups, a bipolar group (Group I) and a control group (Group II). Laminectomy was performed between the L1 and L3levels. In Group I (n=7), a laminectomy was carried out and soft tissue around the spinal cord was coagulated by using a bipolarelectrocautery. In the control group (n=7), only laminectomy was performed. The animals were sacrificed 4 weeks after surgery, andpost-laminectomy epidural fibrosis (PLEF) was evaluated. Macropathological, qualitative and quantitative histological evaluationsas well as immunohistochemical staining including transforming growth factor-β (TGF-β), collagen I and collagen III were performed.RESULTS: The numbers of TGF-β positive cells staining (PCS) were 3.00 ± 0.46 for Group I and 1.00 ± 0.52 for Group II. Thenumbers of collagen I PCS were 2.00 ± 0.93 for Group I and 1.25 ± 0.46 for Group II. The numbers of collagen III PCS were 2.25± 0.76 for Group I, 1.25 ± 0.46 for Group II, and TGF-β PCS than Group II (p≤0.05). Compared with the control group, Group I’sformation of epidural fibrosis was significantly increased.CONCLUSION: Our study clearly demonstrated that the use of bipolar cauterisation is associated with increased PLEF in theexperimental animal model. Thus, limiting the use of bipolar cauterisation may be effective in reducing this complication.