Preventing peridural fibrosis with nonsteroidal anti-inflammatory drugs

Abstract

Peridural fibrosis is one of the more frequent complications of lumbar surgery. Nonsteroidal anti-inflammatory drugs inhibit the inflammatory and fibroblastic response. We performed lumbar laminectomies in 24 rabbits, divided into two groups. The experimental group received 5 mg/kg/day of aceclofenac for 7 days and the control group received 1 cm(3) of physiological saline. The samples were stained using immunohistochemical methods. The cellular populations in the inflammatory reaction and the thickness of the fibrous membrane were quantified. The mean of the fibrous area was always less in the rabbits of the experimental group compared to controls (47% less at 2 weeks and 41% less at 4 weeks). We observed an 8% decrease in the number of fibroblasts with antivimentin monoclonal antibodies in the experimental group. In this model, aceclofenac inhibits the presence of inflammatory cells in the fibrous scar in the early stages and reduces the extension of adhesions without adverse reactions.

Fig. 1

This figure shows the fibroblasts as positive-vimentin cells in brown color (original magnification, ×250)

Fig. 2

We can observe the detection of the area of fibrosis, in false color (orientation: posterior region is at the top of this figure)

Fig. 3

We performed the automatic detection of the fibroblasts, in false color

Fig. 4

a We can see the fibrous adherence to the dura in the study group at 4 weeks (stain, hematoxylin and eosin; original magnification, ×40). M spinal marrow, D dura mater and F fibrosis. b We can observe the fibrous adherence to the dura in the control group at 4 weeks (stain, hematoxylin and eosin; original magnification, ×40). M spinal marrow, D dura mater and F fibrosis