The dural healing response to the local firoblast growth factor-2 on experimental rat cerebro-spinal fluid leakage model

SUMMARYInappropriate dural closure may lead to life threatening complications such asmeningitis, encephalitis, chronic subdural hematoma and effusions. Various materials andsurgical techniques have been tried to achieve a water-tight dural closure however; theultimate method to prevent CSF leakage is yet to be discovered. has not been discovered yetThe effects of locally applied FGF-2, a compound proven to improve wound healing,on dural healing and prevention of CSF leakage were evaluated in this study. A total of 32Wistar male rats were randomly assigned into two groups as the control and FGF-2 group. Allof the animals underwent two level thoracic laminectomy and dural opening. Followingobservation of CSF leakage, autologous blood patch was applied locally to the incised dura ofthe control group and 1µg of FGF-2 to the study group. The groups are further divided intotwo subgroups, 8 rats in each. Two subgroups, one from each arm of the study, weresacrificed on the 3rd postoperative day and the remaining were sacrificed on the 6thpostoperative week. Laminectomy site of each animal was excised en bloc and evaluatinghistopathologically according to the dural healing criteria described by He et al. Comparisonof the following subgroups revealed statistically significant difference: early control-latecontrol, early control-late study and early study - late study. These results were concordantwith the normal healing process. On the other hand, there were no statistically significantdifference among early control-early study and late control-late study subgroups.Nevertheless, the dural healing of both early and late study subgroups was better than that ofthe control group. In our opinion, application time and dosage are the main factors thatimpede and limit desired dural healing.Consequently, the effects of locally administered FGF-2 on dural healing in order toprevent devastating complications that can be associated with CSF leakage require furtherevaluation.