Document Detail


Inhibition of epidural fibrosis after microendoscopic discectomy with topical application of mitomycin C: a randomized, controlled, double-blind trial.
MedLine Citation:
PMID:  23473374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The authors conducted a study to evaluate the effects and the safety of locally applied mitomycin C (MMC) on epidural fibrosis after microendoscopic discectomy (MED).
METHODS: Seventy-five patients undergoing single-level unilateral MED for lumbar disc herniation were randomly assigned to receive cotton wool impregnated with either 0.5 mg/ml MMC or saline applied at the site of discectomy for 5 minutes. Outcome measures included degrees of pain severity, functional disability, physical symptoms, and quantitative evaluation of postoperative epidural fibrosis shown on follow-up lumbar contrast-enhanced MRI.
RESULTS: Sixty-two patients completed the follow-up. Neither serious drug adverse effects nor clinically significant laboratory adverse effects were observed. Patients in both groups showed similar clinical recoveries postoperatively. A statistically significant difference (p < 0.05) between the 2 treatments was shown in a quantitative evaluation of postoperative MRI-documented epidural fibrosis in the MMC group and the saline group using a modified grading system. The mean cross-sectional areas of epidural fibrosis were 7.32-70.06 mm(2) in the MMC group and 22.94-90.48 mm(2) in the saline group. The epidural fibrosis index ranged from 0.0296 to 0.3267 in the MMC group and from 0.1191 to 0.3483 in the saline group. A significant difference was also observed using the Ross grading system to evaluate postoperative MR images.
CONCLUSIONS: Although no benefit was observed clinically, the authors observed a notable reduction of epidural fibrosis after MED radiologically, with 0.5 mg/ml MMC locally applied and no clinical side effects.
Authors:
Lei Liu; Tao Sui; Xin Hong; Xiaotao Wu; Xiaojian Cao
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2013-03-08
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  18     ISSN:  1547-5646     ISO Abbreviation:  J Neurosurg Spine     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-02     Completed Date:  2013-07-02     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  421-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Adult
Diskectomy / adverse effects,  instrumentation,  methods*
Double-Blind Method
Epidural Space / drug effects,  pathology*
Fibrosis
Humans
Lumbar Vertebrae / surgery*
Mitomycin / administration & dosage*,  adverse effects
Nucleic Acid Synthesis Inhibitors / administration & dosage,  adverse effects
Postoperative Complications / pathology*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Nucleic Acid Synthesis Inhibitors; 50SG953SK6/Mitomycin
Comments/Corrections
Comment In:
J Neurosurg Spine. 2013 Nov;19(5):647-8   [PMID:  23992433 ]
J Neurosurg Spine. 2013 Nov;19(5):648-9

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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