Abstract
BackgroundEpidural fibrosis (EF) is a common complication after laminectomy. Salvianolic acid B (Sal B) is a major bioactive component of a traditional Chinese medical agent, Salvia miltiorrhiza, which has shown anti-inflammatory, anti-fibrotic and anti-proliferative properties. The object of this study was to investigate the effect of Sal B on the prevention of epidural fibrosis in laminectomy rats.MethodsA controlled double-blinded study was conducted in sixty healthy adult Wistar rats that underwent laminectomy at the L1-L2 levels. The rats were randomly divided into 3 groups of 20: (1) Sal B treatment group; (2) Vehicle group; (3) Sham group (laminectomy without treatment). All rats were sacrificed 4 weeks post-operatively. The extent of epidural fibrosis, fibroblast proliferation and the expression of vascular endothelial growth factor (VEGF) and inflammatory factors were analyzed.ResultsThe recovery of all rats was uneventful. In the laminectomy sites treated with Sal B, the dura mater showed no adhesion. Collagen deposition was significantly lower in the Sal B group than the other two groups. In addition, both fibroblast and inflammatory cell counting in the laminectomy sites treated with Sal B showed better grades than the other two groups. The expression of VEGF and inflammatory factors in operative sites also suggested better results in the Sal B group than the other two groups.ConclusionsSal B inhibits fibroblast proliferation, blood vessel regeneration, and inflammatory factor expression. Thus, Sal B is able to prevent epidural scar adhesion in post-laminectomy rats.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-337) contains supplementary material, which is available to authorized users.
Highlights
Epidural fibrosis (EF) is a common complication after laminectomy
In the present study in laminectomized rats, we evaluated the efficacy of Salvianolic acid B (Sal B) in the prevention of EF
Animals were randomly divided into three groups (20 rats in each group): 1) Sal B treatment group (Sal B 30 mg/kg, diluted in saline); 2) Vehicle group; 3) Sham group
Summary
Epidural fibrosis (EF) is a common complication after laminectomy. The object of this study was to investigate the effect of Sal B on the prevention of epidural fibrosis in laminectomy rats. Failed back surgery syndrome (FBSS) is gaining attention from both lumbar surgeons and lumbar laminectomy patients. FBSS occurs in 8-40% of patients who undergo lumbar disc surgery [1]. Recurrent persistent low back pain and chronic nerve radicular are the main characteristics for FBSS [2]. Epidural fibrosis (EF) is widely accepted to be the main contributor to FBSS [3,4,5]. EF, as a scar tissue adjacent to the dura mater following lumbar laminectomy, can lead to extensive nerve roots and dural mater adhesions. EF could cause restriction of nerve root mobility, dural compression and spinal canal stenosis [6]
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