Abstract
Introduction
Epidural fibrosis is one of the source of postoperative pain which is occurred by repeated surgeries. However, it was not known between epidural fibrosis caused by repeated spinal surgery and pain-related protein which is released at the dorsal root ganglion that makes spinal pain syndrome. Using rat spinal surgery epidural fibrosis and adhesion model, we investigate the role of spinal epidural adhesion caused by repeated epidural fibrosis, and we checked the dural thickness of the extent of epidural fibrosis and learn the proportional extent. And, we investigate on rat ganglion expression of MAPK/ERK by direct measurement of the amount of pain-related protein by using of immunohistochemistry and western blot.
Material and Methods
We divided the repeated surgery Sprague Dawley rat in three groups in 3 weeks' interval. Group A was first spinal laminectomy surgery group, and group B was two repeated surgery at the interval of 3 weeks, and finally Group C is three repeated surgery group at an interval of 3, 6, and 9 weeks. We humanely killed rat and checked dural thickness at each group and gathered spinal cord and performed immunohistochemistry p38, ERK, and JNK on each group. Finally, we checked western blot to check the expression of phosphorylated ERK, p38, and JNK. The checked expression levels were compared.
Results
Groups A, B, and C significantly increased the thickness of epidural fibrosis. The immunohistochemistry and western blot results of ERK and p38 expression was increased in serial controls A, B, and C. But, JNK expression increases from group A at a different pattern. By western blot, phosphorylation of ERK, p38 also increased in serial pattern control A, B, and C.
Conclusion
Repeated epidural spinal surgery while increasing the thickness of the ganglion stimulation of pain-related factors causing pain and neurogenic cause was determined to be capable of providing.