Effect of Local N-acetyl-cysteine in the Prevention of Epidural Fibrosis in Rat Laminectomy Model

Asian J Neurosurg. Jul-Sep 2018;13(3):664-668. doi: 10.4103/ajns.AJNS_294_16.


Background: Epidural fibrosis is a major contributing factor to the onset of failed back syndrome. Many studies have attempted to prevent this physiological response. Interestingly, N-acetyl-cysteine (NAC) has been effective in some cases in the treatment of pulmonary fibrosis.

Objective: The objective of this study was to determine whether local NAC is an effective way to prevent epidural fibrosis after laminectomy in rats.

Materials and methods: Twenty Wistar rats were used in this study. Animals were divided into two groups: NAC group and a control group. We performed two-level laminectomy (L4-L5) in these rats. Rats in the control group just had laminectomy, and in the other group, L4 and L5 laminectomy followed by local treatment with NAC. Four weeks later, the rats were killed, and the laminectomy level was subjected to histopathological examination to evaluate epidural fibrosis and fibroblast density.

Results: Histopathological examination showed that after 4 weeks of surgery the NAC group had significantly less epidural fibrosis and fibroblasts compared with control group.

Conclusion: Our findings indicate that NAC decreased spinal epidural fibrosis after laminectomy in rats.

Keywords: Epidural fibrosis; N-acetyl cysteine; failed back syndrome; fibroblast; laminectomy; rat.