Esat KİTER, Ertan ER, Nilay TURK, Murat OTO, Semih AKKAYA

Spinal cerrahide istenmeyen kemik dokusu oluşumunun inhibisyonunda 5-florourasilin etkinliği: Spontan spinal füzyonun sıçan modelinde histolojik değerlendirmesi

Amaç: Bu çalışmanın amacı, antiproliferatif bir ajan olan 5-florourasilin (5FU) deneysel sıçan modelinde spinal kemik oluşumunun inhibisyonuna etkisinin araştırılması idi. Çalışma planı: Altı aylık 30 adet Sprague-Dawley sıçan çalışmaya alındı ve 3 grup oluşturuldu. Spontan füzyon modelinde L4-L5 omurlarının posterior elemanlarında noktasal kanama oluşturmak için bisturi ile agresif periostal soyma işlemi gerçekleştirildi. Spinöz çıkıntılar tellerle tespit edildi ve herhangi bir greft materyali uygulanmadı. Grup 1’e Adcon-L, Grup 2’ye tek dokunuş tekniği ile 5FU uygulanırken, Grup 3 kontrol grubunu oluşturdu. Dört hafta sonra sıçanlar sakrifiye edildi ve histolojik inceleme için örnekler alındı. Bulgular: Bu çalışmada 5FU’nun, kontrol grubuna kıyasla, fibroblast ve enflamatuvar hücre yoğunluğu ve kemik formasyonunu önemli ölçüde inhibe ettiği gözlendi. Ayrıca, 5FU’nun kemik formasyonu ve enflamatuvar hücrelerin inhibisyonu açısından Adcon-L’ye göre belirgin şekilde üstün olduğu saptandı (p=0.0001). Çıkarımlar: Çalışmamız 5FU’nun spinal cerrahide füzyon, fibrozis ve istenmeyen skar doku oluşumunu inhibe edebildiğini göstermiştir. 5FU’nun lokal uygulama dozuyla ilgili gelecekteki çalışmalar sonrası insanlarda istenmeyen füzyonun inhibisyonu için kullanılabileceği düşüncesindeyiz.

Anahtar Kelimeler:

5-florourasil; spinal füzyonun inhibisyonu; spontan spinal füzyon

Efficacy of 5-Fluorouracil in inhibition of unintended bone formation in spinal surgery: a histological evaluation on a rat model of spontaneous spinal fusion

Objective: The aim of this study was to investigate the influence of the antiproliferative agent 5-Fluorouracil (5FU) over inhibition of spinal bone formation in an experimental rat model.Methods: The study included 30 6-month-old Sprague-Dawley rats divided into 3 groups. Aggressive periosteal denuding was performed by scalpel to induce punctuate bleeding in the posterior elements of the L4-L5 vertebrae in the spontaneous fusion model. Spinous processes were fixated by wires and no graft substitute was applied. Adcon-L was applied in Group 1, single-touch technique 5FU in Group 2. Group 3 was the control group. Rats were sacrificed at 4 weeks and specimens acquired for histological examination.Results: 5FU substantially inhibited fibroblast and inflammatory cell densities as well as bone formation compared to the control group. 5FU was considerably superior to Adcon-L with regard to inhibition of bone formation and inflammatory cells (p=0.0001).Conclusion: 5FU can inhibit fusion, fibrosis and unwanted scar tissue in spinal surgery. We believe that after further studies on its local delivery dose, it can be used in humans for inhibition of unintended fusion.

Keywords:

5-Fluorouracil, inhibition of spinal fusion spontaneous spinal fusion,

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