Abstract
Laminectomy can effectively decompress the spinal cord and expand the vertebral canal. However, the fibrosis that appears may cause adherence and recompression of the spinal cord or/and nerve root, which may cause failed back syndrome (FBS) and make the reexposure process more difficult. Reconstruction of the epidural fat may be an ideal method to achieve satisfactory results. Thirty-six New Zealand rabbits were randomly divided into three groups: control, extracellular matrix (ECM), and ECM+aMSCs groups. Saline, ECM gel, and ECM+aMSC complex were placed, respectively, at the fifth lumbar vertebrate of the rabbits. Epidural fat and fibrosis formation were detected by magnetic resonance imaging (MRI) and histologically at the 4th, 8th, and 12th weeks. Quantitative RT-PCR was used to detect the expression of interleukin 6 (IL-6) and transforming growth factor β (TGF-β). MRI and Oil Red O staining revealed epidural fat formation at the 12th week in the ECM+aMSCs group. Hematoxylin and eosin staining showed that the numbers of fibroblasts in the ECM gel and ECM+aMSCs groups were less than the control group at the 4th and 8th weeks (p < 0.05). Masson's trichrome staining showed that the proportion of collagen fibers in the ECM gel and ECM+aMSCs group was lower than the control group (p < 0.05). Quantitative RT-PCR showed the expressions of TGF-β and IL-6 were lower in the ECM gel and ECM+aMSCs group than those in the control group (p < 0.05) at the 4th week, but higher at the 8th week. We successfully reconstructed the epidural fat with ECM gel and aMSC complex; additionally, IL-6 and TGF-β cytokines were lower at early stage after laminectomy. Impact statement Our study revealed that epidural fat formed at the 12th week in the extracellular matrix (ECM) plus mesenchymal stem cell (MSC) group after laminectomy in rabbits; additionally, transforming growth factor β (TGF-β) (fibrosis) and interleukin 6 (IL-6) (inflammation) expression was reduced. Thus, we believe that our study makes a significant contribution to the literature because we were able to successfully reconstruct the epidural fat with an ECM gel combined with MSCs and reduce local inflammation.
Highlights
Laminectomy can effectively decompress the spinal cord and expand the vertebral canal
Hematoxylin and eosin (H&E) staining showed that the numbers of fibroblasts in the extracellular matrix (ECM) gel and ECM+adipogenic WJ-MSCs (aMSCs) groups were less than the control group at the 4th and 8th weeks (P
Quantitative real-time PCR (RT-PCR) showed the expressions of TGF-β and IL-6 were lower in the ECM gel and ECM+aMSCs group than the control group (P
Summary
Laminectomy can effectively decompress the spinal cord and expand the vertebral canal. The fibrosis that appears may cause adherence and recompression of the spinal cord or/ and nerve root, which may cause Failed Back Syndrome (FBS) and make the re-exposure process more difficult. Fibrosis appears at epidural adhering and recompresses the spinal cord or/ and nerve root, plays an important role in the recurrence of back and leg pain after spinal surgery called Failed Back Syndrome (FBS)1 ,and makes the re-exposure of the dura without durotomy more difficult. Fibroblasts play an important role in the formation of epidural fibrosis due to the proliferation, migration, and secretion of numerous collagen fibers[2,3]. The biomaterials used for the epidural fat reconstruction were mainly solid membrane, such as PLGA membrane, amniotic membrane, Adcon-L, and so on[10,11]. These solid membranes have several shortcomings for epidural fat reconstruction, such as their rigidity (which may cause compression again) and lack of amorphous state (as it cannot conform to the defect shape)
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