Effect Of Curcumin On The Prevention And Treatment Of Rat Epidural Fibrosis

Background: Laminectomy is a routine procedure in the operation of symptomaticlumbar disc herniation(LDH). Coloboma caused by laminotomy is restored by fibrousconnective tissue hyperplasia through inflammation reaction, granulation tissueproduction and scar tissue production basic pathology course. Foundation is a series ofactivity of inflammation cell and restore cell. Postoperative peridural fibrosis may causethe extensive adhesion around epidural and nerve root. Untoward scar formation is themain reason of failed back surgery syndrome (FBSS), badly influencing the surgicalresults and prognosis. So, the control of scar formation has been one of the mainconcerns in spine surgery. To prevent the postlaminectomy adhesion are of importanceto the curative effect of spine surgery.Objective: Curcumin is traditional Chinese medicine that potentially suppressfibroblast proliferation after surgery. The mechanism and the effects of the prevention ofscar formation after Laminectomy by a curcumin is explored through an experiment inrats.Methods: Laminectomy was performed in L1on36rats which had been dividedinto3groups randomly and resulted in the status of0.2×0.5cm lamina defect. Applydifferent treatments on the3groups, group A left uncovered, group B covered withcollagen sponge, group C with collagen sponge curcumin. Take out integral specimensof the one segments at the4thpostoperative week to do the following proceduresrespectively；grossly anatomical evaluation and appraise the degree of scar adhesiongrossly, hydroxyproline (HOP) assay, histological examination on the conditions ofepidural adhesion and inflammation of each group after H.E and Massion dyeing, thenimaging analysis for the collagen tissue area measurement and fibroblasts count. Results: According to Rydell’s criterion sever peridural adhesion was formed in group A、Band no adhesion was formed in group C at4weeks post-operative. The level of hydroxyprolinein scar tissue was determined, Statistical analysis showed that there were significantdifference between C and A, C and B(P＜0.05). Among the study groups B and A,which has a significant difference(P＞0.05).The light microscopy observation and image analysis: All specimens of group Ashowed dense epidural fibrosis with marked dural adherence. A great lot of fibroblastswere observed. In group C, the fibrous connective tissue was thin and the structural ofscar tissue was loose. There was evidence gap between dura and scar tissue. The area ofperidural fibrosis and the counting of fibroblasts of group A and C showed significantdifference(P＜0.05). Incomplete dural adherence was found in group B. The countingof fibroblasts showed no significant difference between group B and A(P＞0.05).Conclusions: Peridural fibrosis can be a devastating condition that develops afterlaminectomy. Curcumin can suppress scar tissue hyperplasia after surgery. Topicalapplication of Curcumin may be a successful method of preventing postlaminectomyperidural fibrosis and induced no side effects.The curcumin not only have effect inprevention of peridural adhesion after laminectomy, but also provide a new method toclinical study. The curcumin which we had applied, have a good prospect for clinicalgeneralization.