Pentoxifylline Inhibits Epidural Fibrosis in Post-Laminectomy Rats

Abstract

BackgroundThe aim of this experimental study was to investigate the effectiveness of intramuscular pentoxifylline in the prevention of postoperative fibrosis.Material/MethodsWe divided 16 adult Wistar albino rats into 2 equal groups: treatment and control. Both groups underwent L1 vertebral total laminectomy to expose the dura. The intramuscular treatment group received pentoxifylline. Four weeks later, epidural fibrosis was studied in both groups using electron microscopy, light microscopy, histology, biochemistry, and macroscopy.ResultsThe evaluation of epidural fibrosis in the 2 groups according to macroscopic (p<0.01) assessment and light microscopy revealed that epidural scar tissue formation was lower in the treatment group compared to the control group (p<0.001) and the number of fibroblasts was also decreased significantly in the pentoxifylline-treated group (p<0.05). More immature fibers were demonstrated in the treatment group by electron microscopy in comparison with the control group. In biochemical analysis, a statistically significant decrease was detected in hydroxyproline, which indicates fibrosis and myeloperoxidase activity, and shows an inflammatory response (P<0.001).ConclusionsSystemic pentoxifylline application prevents postoperative epidural fibrosis and adhesions with various mechanisms. Our study is the first to present evidence of experimental epidural fibrosis prevention with pentoxifylline.

A Novel Radiotherapy Approach for Keloids with Intrabeam

“…During wound healing after surgery, balancing of collagen formation and degradation is disturbed or destroyed, resulting in the accumulation of collagen fibers and the formation of a large number of collagen fibrils, rendering the anabolism of collagen greater than catabolism [25]. Immature fibroblasts occupy most of the incisions within 24 h of surgery [26]. Unstable collagen fibers from these cells are the main component and are more sensitive to radiation than other fibers.…”

Prospective application of stem cells to prevent post‐operative skeletal fibrosis

“…To help alleviate the side effects of drugs, controlled release systems have been developed to reduce post‐operative skeletal fibrosis, including MMC controlled‐release films, liposome‐encapsulated HCPT and gelatin combined with dexamethasone, decorin and parecoxib . Moreover, other drugs and proteins are used to prevent post‐operative skeletal fibrosis, including simvastatin, rosuvastatin, resveratrol and all‐trans retinoic acid, verapamil, melatonin, taurine, citicoline, pentoxifylline and transduction with lentivirus carrying extracellular signal‐regulated kinase 2 . Additionally, oral application of pentoxifylline and percutaneous lysis of epidural fibrosis have achieved success in patients.…”

Impact of radial extracorporeal shock wave therapy in post-laminectomy epidural fibrosis in a rat model

“…Although the methods that create a mechanical barrier show different efficacy, they significantly reduce the development of epidural fibrosis. In addition, several studies are available in the literature reporting significantly reduced epidural fibrosis, using agents such as pentoxifylline[ 23 ] with an anti-fibroblastic effect, and diltiazem,[ 20 ] an fibroblast growth factor-2 inhibitor.…”