Turkish Neurosurgery
Evaluation of Bevacizumab for The Treatment of Epidural Fibrosis by Immunohistochemical Staining for CD105 and Osteopontin
Ilhan Yilmaz1, Uzay Erdogan2, Osman Tanriverdi2, Omur Gunaldi2, Utku Adilay3, Muhammed Omeroglu4, Canan Tanik5, Bekir Tugcu2
1University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Neurosurgery, İstanbul,
2University of Health Sciences, Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Neurology, Neurosurgery and Psychiatry, Neurosurgery, İstanbul,
3Balıkesir University, Medical Faculty, Neurosurgery, Balıkesir,
4Toyotasa State Hospital, Neurosurgery, Sakarya,
5University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Pathology, İstanbul,
DOI: 10.5137/1019-5149.JTN.22633-18.2

Aim:The etiology and mechanism underlying epidural fibrosis (EF), one of the most frequent causes of failed back surgery after laminectomy, remain unclear. Despite numerous potential modalities evaluated for EF prevention, treatment approaches are limited. This study aimed to evaluate bevacizumab for EF treatment in an experimental rat model using histopathology as well as immunohistochemical staining for CD105 and osteopontin (OPN).Material and Methods:Wistar Albino rats underwent either laminectomy alone to induce EF (group I, control) or laminectomy plus local bevacizumab treatment (group II). The degree of EF was compared between groups using the current histopathological grading method as well as immunohistochemistry for CD105 and OPN. In addition, the consistency of EF staging using CD105 and OPN expression was compared to that using histopathology.Results:The grade of EF was significantly lower in group II than in group I based on the fibroblast count and fibrosis density determined using histopathology, as well as by CD105 expression determined using immunohistochemistry. In contrast, OPN expression was not a reliable marker for EF evaluation because it did not show a significant difference between the two groups.Conclusion:Bevacizumab prevented EF development as assessed using both histopathology and CD105 expression. CD105 is a potentially reliable marker for the immunohistochemical grading of EF, in contrast to OPN.

Corresponding author : Osman Tanriverdi