Turkish Neurosurgery 2012 , Vol 22 , Num 5
Prevention of Epidural Fibrosis in Rats by Local or Systemic Administration of Citicoline
Mehmet SAVRAN1, Ahmet BEKAR1, Mehmet CANSEV2, Sahsene TOLUNAY3, Ismail Hakki ULUS4, Mevlut Ozgur TASKAPILIOGLU1
1Uludag University, Faculty of Medicine, Department of Neurosurgery, Bursa, Turkey
2Uludag University, Faculty of Medicine, Department of Pharmacology , Bursa, Turkey
3Uludag University, Faculty of Medicine, Department of Pathology, Bursa, Turkey
4Acibadem University, Faculty of Medicine, Department of Pharmacology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.6008-12.0 AIM: The objective of this study was to investigate the effect of citicoline administration on epidural fibrosis which is a frequent complication of lumbar disc surgery with no effective treatment or preventive surgical technique.

MATERIAL and METHODS: Sixty Sprague-Dawley female rats undergoing L4-5 right hemilaminotomy and annular fenestration were arranged in three groups: rats in Group 1 (control group) and Group 2 (topical citicoline group) were applied 0,9% saline and 100 μM citicoline on surgical area, respectively, while rats in Group 3 (systemic citicoline group) received 600 μmol/kg citicoline intraperitoneally. Rats were sacrificed four weeks later and their vertebral colons were removed en bloc. Groups were evaluated according to histological criteria and results were compared using statistical tools.

RESULTS: Compared with control group, significantly less epidural fibrosis, dural adhesion, fibroblast cell density, foreign body reaction, and medulla spinalis retraction were observed in groups treated with topical and systemic citicoline (groups 2 and 3) (p<0,001). No significant difference was found with regard to measured parameters between two treatment groups (p>0,05).

CONCLUSION: Our study demonstrates for the first time in the literature that citicoline may be effective for preventing postoperative epidural fibrosis. However, its mechanism of action and clinical effectiveness must be further investigated. Keywords : Epidural fibrosis, Annular fenestration, Laminatomy, Citicoline, Rat

Corresponding author : Ahmet Bekar, abekar@uludag.edu.tr