Comparison of the Effects of Contractubex Gel and Benzothiazole After Topical Application in an Experimental Model of Epidural Fibrosis in Rats

• Published in: World neurosurgery 2018-09, Vol.117, p.e403-e410
• Main Authors: Bozkurt, Huseyin, Bozkurt, Emel Cicek, Ozpinar, Hulya, Arac, Densel, Kaya, Ismail, Ozer, Hidir, Egilmez, Reyhan
• Format: Article
• Language: English
• Subjects: Epidural fibrosis; Laminectomy; Rat; Topical BT; Topical Contractubex gel
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.06.044

Postoperative epidural adhesion is a frequent cause of failed back surgery syndrome, manifesting with back and leg pain or neurologic deficits. Development of preventive measures for epidural adhesion after laminectomy is critical to improve outcomes of lumbar surgery. We hypothesized that positive effects of topical application of Contractubex (CTX) gel and benzothiazole (BT) individually and in combination could aid in preventing epidural fibrosis in a rat laminectomy model. Rats were randomly assigned to 2 control and 5 experimental groups (n = 8 for each group). The control(−) group received no surgery, whereas the control(+) group underwent laminectomy without any drug administration. In experimental groups, study agents applied to dura mater after laminectomy were 100mgCTX, 2.5%BT, 5%BT; 100mgCTXplus2.5%BT, and 100mgCTXplus5%BT. Laminectomy was performed at the L3 level for all rats. The extent of epidural fibrosis was assessed 4 weeks later macroscopically and histopathologically. Hepatic and renal toxicity of study drugs was assessed histopathologically. Topical CTX and BT individually and in combination reduced epidural fibrosis after laminectomy in rats. Although a meaningful decrease of epidural fibrosis with individual application of CTX and BT (2.5% or 5%) was obtained (P < 0.05), the effect of their combination was more pronounced without meaningful hepatic and renal toxicity (P < 0.05). Combined use of topical CTX and BT could be a potential therapy for epidural fibrosis. Further research with this agents for the prevention of epidural fibrosis is warranted. •Effects of Contractubex and benzothiazole in preventing epidural fibrosis in a rat model were evaluated.•Contractubex, with antifibrosis properties, and benzothiazole, with mainly apoptotic properties, improved neuropathology.•Combined use of these drugs may be a promising strategy for prevention of epidural fibrosis after neurosurgical procedures.