Abstract
With laminectomy being widely accepted as the treatment for lumbar disorders, epidural fibrosis (EF) is a common complication for both the patients and the surgeons alike. Currently, EF is thought to cause recurrent postoperative pain after laminectomy or after discectomy. Angelica sinensis is a traditional Chinese medicine which has shown anti-inflammatory, antifibrotic, and antiproliferative properties. The object of this study was to investigate the effects of Angelica sinensis on the prevention of post-laminectomy EF formation in a rat model. A controlled double-blinded study was conducted in sixty healthy adult Wistar rats that underwent laminectomy at the L1-L2 levels. They were divided randomly into 3 groups according to the treatment method, with 20 in each group: (1) Angelica sinensis treatment group, (2) saline treatment group, and (3) sham group (laminectomy without treatment). All rats were euthanized humanely 4 weeks after laminectomy. The hydroxyproline content, Rydell score, vimentin cells density, fibroblasts density, inflammatory cells density, and inflammatory factors expressions all suggested better results in Angelica sinensis group than the other two groups. Topical application of Angelica sinensis could inhibit fibroblasts proliferation and TGF-β1 and IL-6 expressions and prevent epidural scar adhesion in postlaminectomy rat model.
Highlights
Laminectomy is widely accepted across the medical community as the treatment of choice in lumbosacral disorders
We discovered that the Angelica sinensis (Oliv.) Diels (Apiaceae) agent demonstrated curative properties as well in laminectomy rat
In our rat laminectomy model, we investigated whether A. sinensis attenuates epidural fibrosis (EF) by regulating the expressions of interleukin 6 (IL6), transforming growth factor-β1 (TGF-β1), and hydroxyproline, which are suggested to be involved in the promotion and/or development of EF
Summary
Laminectomy is widely accepted across the medical community as the treatment of choice in lumbosacral disorders. As early as 1995, researchers reported as many as over one million patients worldwide who underwent lumbosacral surgery to treat disc herniation [1]. The literature reports that patients could suffer from continued pain in the lower posterior trunk and/or lower extremities after lumbar laminectomy, this is commonly referred to as the “failed back surgery syndrome” (FBSS) [2]. There are no effective treatments with an established EF, and the success rates of reoperations for FBSS are poor [6]. It seems that minimally invasive surgical technique (MIST) is the most commonly used preventative measures against complication. Extensive studies on this have been conducted on animals with several differing components, such as autologous fat grafts, AdconL, animal collagen membranes, Gelfoam, anti-inflammatory
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