Effects of Low and High Molecular Weight Hyaluronic Acids on Peridural Fibrosis and Inflammation in Lumbar Laminectomized Rats
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Background:Postlaminectomy peridural fibrosis is inevitable. Some studies have compared and identified the effects of high molecular weight hyaluronic acids (HMWHA) and low molecular weight hyaluronic acids (LMWHA) on peridural fibrosis in postlaminectomy animal models. However, no studies have been found that compare pain behaviors between hyaluronic acids or among hyaluronic acids and other solid materials. The purpose of this study was to examine the correlation between pain-related behaviors and histopathologic changes in laminectomized rats using various peridurally administered materials. Methods:Forty male Sprague-Dawley rats, laminectomized at the L5 and L6 levels, were divided into four groups: group C, laminectomy only; group L, laminectomy and LMWHA application; group H, laminectomy and HMWHA application; group F, laminectomy and fat interposition. Pain behaviors were checked before, 3 days, 1 week, and 3 weeks after surgery. Histopathological changes were checked at the L5 level 3 weeks after the surgery. Results:The 50% withdrawal thresholds in groups L and H were higher than that in groups C and F three days after laminectomy (P ＜ 0.05). The paw withdrawal time did not change among the groups and in each group during the study period. Peridural fibrosis in group F was significantly lower than in the other groups (P ＜ 0.05). Conclusions:Hyaluronic acids significantly reduced mechanical allodynia but not thermal hyperalgesia. Peridural fibrosis did not show any correlation with pain behaviors. There have been limited studies on the correlation between peridural fibrosis and pain behavioral change, which should be verified by further studies. (Korean J Pain 2011; 24: 191-198)
Abstract
Background:Postlaminectomy peridural fibrosis is inevitable. Some studies have compared and identified the effects of high molecular weight hyaluronic acids (HMWHA) and low molecular weight hyaluronic acids (LMWHA) on peridural fibrosis in postlaminectomy animal models. However, no studies have been found that compare pain behaviors between hyaluronic acids or among hyaluronic acids and other solid materials. The purpose of this study was to examine the correlation between pain-related behaviors and histopathologic changes in laminectomized rats using various peridurally administered materials. Methods:Forty male Sprague-Dawley rats, laminectomized at the L5 and L6 levels, were divided into four groups: group C, laminectomy only; group L, laminectomy and LMWHA application; group H, laminectomy and HMWHA application; group F, laminectomy and fat interposition. Pain behaviors were checked before, 3 days, 1 week, and 3 weeks after surgery. Histopathological changes were checked at the L5 level 3 weeks after the surgery. Results:The 50% withdrawal thresholds in groups L and H were higher than that in groups C and F three days after laminectomy (P ＜ 0.05). The paw withdrawal time did not change among the groups and in each group during the study period. Peridural fibrosis in group F was significantly lower than in the other groups (P ＜ 0.05). Conclusions:Hyaluronic acids significantly reduced mechanical allodynia but not thermal hyperalgesia. Peridural fibrosis did not show any correlation with pain behaviors. There have been limited studies on the correlation between peridural fibrosis and pain behavioral change, which should be verified by further studies. (Korean J Pain 2011; 24: 191-198)
참고문헌 (36)
- Gill GG, "Pedicle fat grafts for the prevention of scar formation after laminectomy. An experimental study in dogs", Spine, 4, pp.176~186 (1979)
- Kitano T, "Viscous carboxymethylcellulose in the prevention of epidural scar formation", Spine, 16, pp.820~823 (1991)
- Alkalay RN, "Prevention of postlaminectomy epidural fibrosis using bioelastic materials", Spine, 28, pp.1659~1665 (2003)
- Jacobs RR, "Control of postlaminectomy scar formation: an experimental and clinical study", Spine, 5, pp.223~229 (1980)
- Kuivila TE, "Heparinized materials for control of the formation of the laminectomy membrane in experimental laminectomies in dogs", Clin Orthop Relat Res, 236, pp.166~174 (1988)
- Einhaus SL, "Reduction of peridural fibrosis after lumbar laminotomy and discectomy in dogs by a resorbable gel (ADCON-L)", Spine, 22, pp.1440~1446 (1997)
- de Tribolet N, "Clinical assessment of a novel antiadhesion barrier gel: prospective, randomized, multicenter, clinical trial of ADCON-L to inhibit postoperative peridural fibrosis and related symptoms after lumbar discectomy", Am J Orthop, 27, pp.111~120 (1998)
- Yong-Hing K, "Prevention of nerve root adhesions after laminectomy", Spine, 5, pp.59~64 (1980)
- Mikawa Y, "An experimental study on prevention of postlaminectomy scar formation by the use of new materials", Spine, 11, pp.843~846 (1986)
- Songer MN, "Effects of sodium hyaluronate on peridural fibrosis after lumbar laminotomy and discectomy", Spine, 15, pp.550~554 (1990)
- Henderson R, "Attempted experimental modification of the postlaminectomy membrane by local instillation of recombinant tissue-plasminogen activator gel", Spine, 18, pp.1268~1272 (1993)
- Abitbol JJ, "Preventing postlaminectomy adhesion. A new experimental model", Spine, 19, pp.1809~1814 (1994)
- Songer MN, "Analysis of peridural scar formation and its prevention after lumbar laminotomy and discectomy in dogs", Spine, 20, pp.571~580 (1995)
- Welch WC, "Gerszten PC, Toth JM, Nemoto EM, et al. Use of polylactide resorbable film as an adhesion barrier", J Neurosurg, 97(4), pp.413~422 (2002)
- Kato T, "Evaluation of hyaluronic acid sheet for the prevention of postlaminectomy adhesions", Spine J, 5, pp.479~488 (2005)
- Sunblad L, "Studies on hyaluronic acid in synovial fluids", Acta Soc Med Ups, 58, pp.113~238 (1953)
- Rydell N, "Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of osteoarthritis and on granulation tissue formation", Clin Orthop Relat Res, 80, pp.25~32 (1971)
- Dixon AS, "Clinical trial of intra-articular injection of sodium hyaluronate in patients with osteoarthritis of the knee", Curr Med Res Opin, 11, pp.205~213 (1988)
- Swann DA, "Role of hyaluronic acid in joint lubrication", Ann Rheum Dis, 33, pp.318~326 (1974)
- Tobetto K, "Inhibitory effects of hyaluronan on neutrophil-mediated cartilage degradation", Connect Tissue Res, 29, pp.181~190 (1993)
- Sakakibara Y, "Effect of high-molecular-weight sodium hyaluronate on immobilized rabbit knee", Clin Orthop Relat Res, 299, pp.282~292 (1994)
- Wobig M, "The role of elastoviscosity in the efficacy of viscosupplementation for osteoarthritis of the knee: a comparison of hylan G-F 20 and a lower-molecular-weight hyaluronan", Clin Ther, 21, pp.1549~1562 (1999)
- Chaplan SR, "Quantitative assessment of tactile allodynia in the rat paw", J Neurosci Methods, 53, pp.55~63 (1994)
- Massie JB, "Topical high molecular weight hyaluronan reduces radicular pain post laminectomy in a rat model", Spine J, 5, pp.494~502 (2005)
- Hargreaves K, "A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia", Pain, 32, pp.77~88 (1988)
- Dixon WJ, "Efficient analysis of experimental observations", Annu Rev Pharmacol Toxicol, 20, pp.441~462 (1980)
- Yamagami T, "Effects of laminectomy and retained extradural foreign body on cauda equina adhesion", Spine, 18, pp.1774~1781 (1993)
- Lu X, "Responses of macrophages in rat dorsal root ganglia following peripheral nerve injury", J Neurocytol, 22, pp.334~341 (1993)
- Gotoh S, "Effects of the molecular weight of hyaluronic acid and its action mechanisms on experimental joint pain in rats", Ann Rheum Dis, 52, pp.817~822 (1993)
- Kim SH, "An experimental model for peripheral neuropathy produced by segmental spinal nerve ligation in the rat", Pain, 50, pp.355~363 (1992)
- Takenobu Y, "Model of neuropathic intermittent claudication in the rat: methodology and application", J Neurosci Methods, 104, pp.191~198 (2001)
- Ririe DG, "Age-dependent responses to thermal hyperalgesia and mechanical allodynia in a rat model of acute postoperative pain", Anesthesiology, 99, pp.443~448 (2003)
- Rydell N, "Decreased granulation tissue reaction after installment of hyaluronic acid", Acta Orthop Scand, 41, pp.307~311 (1970)
- Weigel PH, "A model for the role of hyaluronic acid and fibrin in the early events during the inflammatory response and wound healing", J Theor Biol, 119, pp.219~234 (1986)
- Balazs EA, "The effect of hyaluronic acid on fibroblasts, mononuclear phagocytes and lymphocytes, In Biology of the fibroblast", pp.237~252 (1973), Academic Press
- van der Gaag R, "The influence of high molecular weight sodium hyaluronate (Healon) on the production of migration inhibitory factor", Curr Eye Res, 6, pp.1433~1440 (1987)