The effect of platelet rıch plasma on epıdural fıbrosıs ın a rat lamınectomy model

The aim of this study is to evaluate the histologic effects of platelet rich plasma which can be obtained from the patient?s own blood and can be used effectively and without side effects to prevent epidural fibrosis; and to compare this effect with free fat flap and collagen matrix. In our study the approval of the ethical committee of experimental animals ( 16 November 2012 dated, 61/2012 Protocol number ) has been received. 29 Wistar albino adult male rats between 250 to 300 grams in weight and with normal motor activity were obtained from Dokuz Eylul University School of Medicine Animal Experiments Laboratory. Basso-Beattie-Bresnahan (BBB) scoring rates were performed and recorded at the preoperative and postoperative period to all subjects for neurological assessment. The subjects were divided into 3 groups. All groups consisted of seven subjects. In Group 1 (fat pad group) only autogenous fat pad applied to the laminectomy site. In Group 2 (collagen matrix group) laminectomy defect was covered with collagen dural matrix in dimension of 4x2.5mm (DuraGen PlusTM , Integra Lifesciences Corporation 311 Enterprise Drive Plainsboro, NJ 08 536). Platelet-rich plasma was applied to the laminectomy areas with single doses as 1.5cc each of rats in Group 3. 7 rats were killed after cardiac puncture blood supplies for the preperation of platelet-rich plasma. One rat was used for the pilot study and not included in the statistical analysis. All 21 rats were sacrified after the 4th week of the operations. Enblock excision of laminectomy site were performed and cleaned with saline solution, and carried to histology laboratory in formaldehyde solution. The histological light microscopy examination was made by one histology specialist with single blind method. Epidural fibrosis grading scale of He et al. is been used. As a result, it was found that the collagen dural matrix leaded statically more fibrosis ad scar development. Although fibrosis grades of free fat flap and the platelet rich plasma group were found similar, the platelet rich plasma application showed slightly lower fibrosis grades. Platelet rich plasma application causes less fibrosis after laminectomy when compared to collagen matrix. Costs and obtaining autogenous can be accepted as PRP?s important advantages.