Turkish Neurosurgery
The effect of halofuginone use on epidural fibrosis after spinal surgery: An animal experiment
MEHMETZEKI YILDIZ2, BARIS PEKER3, TUGRUL CEM UNAL1, ILYAS DOLAS1, CAFER IKBAL GULSEVER1, DUYGU DOLEN4, EVREN SONMEZ5, YAVUZ ARAS1, AYDIN AYDOSELI1, PULAT AKIN SABANCI1, ALTAY SENCER1, ALI NAIL IZGI1
1ISTANBUL UNIVERSITY, NEUROSURGERY, ISTANBUL,
2BAHCESEHIR UNIVERSITY, NEUROSURGERY, ISTANBUL,
3KAGITHANE STATE HOSPITAL, NEUROSURGERY, ISTANBUL,
4YUKSEKOVA STATE HOSPITAL, NEUROSURGERY, HAKKARI,
5KANUNI SULTAN SULEYMAN TRAINING AND RESEARCH HOSPITAL, NEUROSURGERY, ISTANBUL,
DOI: 10.5137/1019-5149.JTN.42998-22.3

Aim:Epidural fibrosis (EF) can cause persistent low back pain after spinal surgery. Type I collagen is the main component of scar tissue formed after spinal surgery, and an antifibrotic agent is necessary for preventing fibrosis. Halofuginone is an antifibrotic agent that has an effect on type I collagen. Our study aimed to investigate the effectiveness of local halofuginone application for spinal EF after lumbar laminectomy in rats.Material and Methods:Forty rats were equally divided into four groups (Groups I–IV; 10 rats in each group), and lumbar laminectomy was performed under general anesthesia. After laminectomy, Group I received saline (NaCl 0.9%) locally (control), Group II received spongostan, Group III received 0.5 mL of halofuginone-impregnated spongostan, and Group IV received 0.5 mL of halofuginone. Spongostan was used to prolong the exposure period of halofuginone. All rats were sacrificed after four weeks and evaluated according to histopathological criteria. A p-value of <0.05 was considered statistically significant.Results:Fibrosis was significantly lower in Group IV than in Group I (p < 0.05). There was no significant difference in fibrosis between Group II/III and Group I. It was observed that spongostan increased fibrosis.Conclusion:Halofuginone helps prevent EF after spinal surgery. However, further clinical and experimental studies are needed to assess its safety in humans.

Corresponding author : CAFER IKBAL GULSEVER