The effect of urokinase in preventing the formation of epidural fibrosis and/or leptomeningeal arachnoiditis

BACKGROUND Epidural fibrosis and leptomeningeal adhesion formation are among the common causes of failed back surgery syndrome. Urokinase has been commonly used in treating aneurysmal subarachnoid hemorrhage and intracerebral hematoma. METHODS In a rat model, the potential of local urokinase in preventing the production of epidural fibrosis due to bleeding was investigated. RESULTS A reduction of approximately 48% in leptomeningeal adhesion formation with the use of urokinase was demonstrated. Adhesion score was 2.300 in the control group and 0.700 in the urokinase treated group on day 42 of the postoperative period. CONCLUSIONS It can be concluded that urokinase has the important effect of preventing the formation of leptomeningeal adhesion, but many more extensive studies clearly need to be done before such material can be clinically used. (C) 1997 by Elsevier Science Inc.