Turkish Neurosurgery 2020 , Vol 30 , Num 2
Less Use of the Bipolar Cautery can Prevent Postlaminectomy Epidural Fibrosis: An Experimental Study in Rats
Vaner KOKSAL1,Tolga MERCANTEPE2,Levent TUMKAYA2,Ibrahim Suat OKTEM3
1University of Health Sciences, Samsun Health Practices and Research Center, Department of Neurosurgery, Samsun, Turkey
2Recep Tayyip Erdogan University, School of Medicine, Department of Histology and Embryology, Rize, Turkey
3Erciyes University, School of Medicine, Department of Neurosurgery, Kayseri, Turkey
DOI : 10.5137/1019-5149.JTN.27544-19.2 AIM: To investigate the role of bipolar electrocautery in the occurrence of epidural fibrosis following lumbar spine laminectomy in a rat model.

MATERIAL and METHODS: Fourteen male Sprague–Dawley rats (age: 4–6 months, weight: 250–300 g) were randomly divided into two groups, a bipolar group (Group I) and a control group (Group II). Laminectomy was performed between the L1 and L3 levels. In Group I (n=7), a laminectomy was carried out and soft tissue around the spinal cord was coagulated by using a bipolar electrocautery. In the control group (n=7), only laminectomy was performed. The animals were sacrificed 4 weeks after surgery, and post-laminectomy epidural fibrosis (PLEF) was evaluated. Macropathological, qualitative and quantitative histological evaluations as well as immunohistochemical staining including transforming growth factor-β (TGF-β), collagen I and collagen III were performed.

RESULTS: The numbers of TGF-β positive cells staining (PCS) were 3.00 ± 0.46 for Group I and 1.00 ± 0.52 for Group II. The numbers of collagen I PCS were 2.00 ± 0.93 for Group I and 1.25 ± 0.46 for Group II. The numbers of collagen III PCS were 2.25 ± 0.76 for Group I, 1.25 ± 0.46 for Group II, and TGF-β PCS than Group II (p≤0.05). Compared with the control group, Group I’s formation of epidural fibrosis was significantly increased.

CONCLUSION: Our study clearly demonstrated that the use of bipolar cauterisation is associated with increased PLEF in the experimental animal model. Thus, limiting the use of bipolar cauterisation may be effective in reducing this complication. Keywords : Bipolar cauterisation, Epidural fibrosis, Failed back syndrome, Post-laminectomy, Thermal damage, Rat

Corresponding author : Vaner KOKSAL, vanerkoksal@hotmail.com