Polycaprolacton/Polylactid-Membran kann Laminektomie-induziertes Wachstum von CGRP- und SP-immunpositiven Nervenfasern in der Dura mater lumbalis von Ratten nicht verhindern

Zusammenfassung

Hintergrund Mechanismen und Prävention des Failed-Back-Surgery-Syndroms sind im klinischen Kontext kaum bekannt. Tierexperimentell konnte gezeigt werden, dass Laminektomien das Wachstum von mutmaßlich nozizeptiven peptidergen Afferenzen in der Dura mater lumbalis von Ratten induziert.

Ziel Evaluierung, ob die postoperative Anwendung einer Polycaprolacton-Polylactid-Membran (Mesofol) die sensorische Hyperinnervation hemmt.

Material/Methoden Erwachsene Lewis-Ratten wurden in 3 Gruppen unterteilt: Kontrolle (keine Manipulation), Laminektomie und Laminektomie + Mesofol. Sechs Wochen postoperativ wurden die Durae entfernt, CGRP- und SP-haltige Afferenzen immunhistochemisch markiert und deren Innervierungsdichte bestimmt.

Ergebnisse In den Kontrollen wurden die CGRP- und SP-positiven Neurone überwiegend in den ventralen, jedoch nur spärlich in den dorsalen Abschnitten der jeweiligen Dura gefunden. Nach Laminektomie nahm ventral die Anzahl der immunpositiven Afferenzen signifikant zu, was in einem dichten Netzwerk von Nervenfasern resultierte. In den dorsalen Regionen wurde ebenfalls eine Zunahme immunpositiver Nervenfasern sowie neuronales Aussprossen und Wachstum beobachtet. Das Bedecken der Durae mit Mesofol nach Laminektomie hatte keinen signifikanten Einfluss auf das Nervenfaserwachstum.

Schlussfolgerung Die Verwendung von Mesofol konnte den Laminektomie-induzierten Dichteanstieg der peptidergen Afferenzen weder verhindern noch signifikant herabsetzen.

Schlüsselwörter

Laminektomie - biologisch abbaubare Membran - Mesofol - CGRP-/SP-immunpositive Nervenfasern - Schmerzen nach Rückenoperation

Publication History

Received: 22 February 2022

Accepted: 26 April 2022

Article published online:
01 August 2022

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