LAUSR

AIM Epidural fibrosis is a major cause of postlaminectomy syndrome or "failed back surgery syndrome," which may occur after spinal surgical interventions. It reduces the quality of life, and is characterized by persistent back/low back pain and radicular leg pain. The aim of this experimental study was to investigate the efficacy of locally applied batimastat after laminectomy in preventing postoperative epidural fibrosis. MATERIAL AND METHODS Thirty-two Wistar albino male rats weighing 200-250 g were used. The rats were assigned to four different groups (I-Control group, II-sham group, III-Laminectomy+Batimastat group, and IV-Laminectomy+Spongostan group). The rats were euthanized 28 days after surgery before TNF-α, IL6, IL-1β, IL10, TGF-β1, and MMP9 gene expression levels of tissue in the surgical area were determined with qPCR. TNF-α, IL6, and IL10 protein levels were also measured in both tissue and plasma. In addition, the surgical area was evaluated by histopathological and immunohistochemical methods. RESULTS TNF-α, IL6, and IL-1β gene expression levels were higher in the batimastat group than in the control group. Whereas IL10 gene expression levels increased about two-fold in the sham and spongostan groups, in the batimastat group, it was similar to that in the control group. TGF-β1 gene expression was three-fold higher in the sham group but was similar to that in the control group in both batimastat and spongostan groups. MMP9 gene expression levels significantly decreased only in the batimastat group. In addition, fibrosis score, fibroblast cell count, inflammatory cell count, and CD105 decreased in the batimastat group relative to the control. CONCLUSION Molecular and pathological examination results suggested that batimastat is an effective agent in reducing the occurrence of epidural fibrosis after laminectomy.