Effectiveness of autologous fat graft and methylprednisolone as single and combination therapy in the prevention of epidural fibrosis

Objectives: Epidural fibrosis is a common complication following laminectomy, contributing to failed back surgery syndrome characterized by back pain and radiculopathy. Despite ongoing research, no consensus exists on the best method to prevent epidural fibrosis. This animal study aimed to compare the effectiveness of autologous fat grafts and methylprednisolone as single and combination therapies in preventing epidural fibrosis. Methods: Four groups of rats, each containing 7, underwent different treatments post-lumbar laminectomy: A control group, a group receiving methylprednisolone in the epidural space, a group receiving an autologous fat graft, and a group receiving both methylprednisolone and an autologous fat graft. After 6 weeks, the formation of epidural fibrosis was evaluated through histopathological examination based on the classification. The degree of epidural fibrosis was analyzed. Results: The autologous fat graft group exhibited the lowest degree of fibrosis (Grade 1). Comparisons between this group and the others showed a significant difference (P < 0.05). No significant difference was observed between the control, methylprednisolone, and combination groups (P > 0.05). Conclusion: The study demonstrated a significant reduction in histological epidural fibrosis using autologous fat grafts compared to methylprednisolone and their combination in animal models. Histological analysis indicated that autologous fat grafts resulted in a lower degree of fibrosis following laminectomy.