ABSTRACT
OBJECTIVE: An animal model of laminectomy in rats was used to study scar tissue formation around the spinal cord. Bevacizumab (BV) [a recombinant, humanized, monoclonal antibody targeting vascular endothelial growth factor], 5-Fluorouracil (5-FU) and BV+5-FU was tested in this system for its ability to decrease fibrous tissue formation. MATERIALS AND METHODS: Twenty-eight Sprague Dawley rats were used in this sudy. Rats were divided into four groups; a control group, a BV group, a 5-FU group and a BV+5-FU group. L1-2 laminectomies were performed on the rats. The medicated groups were treated with topical drug administration. After 6 weeks, the rats were sacrified and histologic sections prepared from the spines were examined and graded by a pathologist. Epidural fibrosis and fibroblast density were evaluated under light microscope. RESULTS: BV (Avastin: Genentech, San Francisco, CA, USA) significantly reduced the density of the scar tissue undermining the laminas (p < 0.005). Monotherapy with 5-FU did not change the scar formation in the back (p = 0.317). Combination of 5-FU and BV was more effective on reducing the epidural fibrosis after laminectomy on rats (p < 0.001). CONCLUSIONS: Bevacizumab reduced the spinal epidural fibrosis significantly that developed in rats after laminectomy and 5-Fluorouracil combination had a synergic effect. Further investigations under the light of these findings may help to reduce epidural fibrosis formation after laminectomy.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Epidural Space/pathology , Fluorouracil/therapeutic use , Laminectomy/adverse effects , Postoperative Complications/drug therapy , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Animals , Bevacizumab , Drug Therapy, Combination , Epidural Space/drug effects , Fibrosis , Lumbar Vertebrae/surgery , Male , Rats, Sprague-DawleyABSTRACT
In childhood, a significant proportion of giant aneurysms usually occur at the vertebrobasilary system. Nonetheless, giant totally thrombosed aneurysm which only involves the vertebral portion of the vertebrobasilary system is very rare. Up to this time, in childhood, a few giant aneurysm originating from vertebral artery have been reported, and to our knowledge only one case was reported to be totally thrombosed. The enlargement tendency of totally thrombosed aneurysms and management of these cases are still controversial. Thus, diagnosis and follow-up of cases where a radical approach could not be performed require a multi-modality radiologic approach. In this study, we reported a case of angiographically occult giant thrombosed vertebral artery aneurysm, which is extremely rare, and discussed the importance of CT and MRI in evaluation of these patients before surgical treatment.
