The effect of bevacizumab on spinal epidural fibrosis in a postlaminectomy rat model

Abstract

Spinal epidural fibrosis is an inherent result of surgical trauma after laminectomy. The conditions in which epidural fibrosis is excessive are in the etiology of failed back syndrome. There have been many attempts to prevent formation of epidural fibrosis. Bevacizumab which is an anti-angiogenic medication, inhibits the effect of VEGF and thereby decreases the new blood vessel formation and as a result prevents adhesions. This study shows the effect of bevacizumab on spinal epidural fibrosis developing after laminectomy in rats. In this study, 20 Wistar rats were used. Rats were divided into two groups; a control group, and a bevacizumab group. Three-level laminectomy was performed on the rats. Rats in the control group only had the laminectomy. In the bevacizumab group, 2.5 mg/kg bevacizumab diluted in 0.9% NaCl with a factor of 1:10 impregnated on cotton was applied on the dura topically for 5 minutes. Three weeks later, rats were sacrificed for histopathologic examination. Epidural fibrosis tissue was graded following sacrifice. Statistically, it was found that the bevacizumab group had significantly less epidural fibrosis compared to the control group (p < 0.05). Bevacizumab reduced the spinal epidural fibrosis significantly that developed in rats after laminectomy via its anti-VEGF effect by blocking VEGF receptors.