An experimental study of inhibiting the epidural scar formation following lumbar spinal surgery
- VernacularTitle:腰椎手术后硬膜外腔瘢痕预防的实验研究
- Author:
Shaolei LU
;
Gongyi HUANG
- Publication Type:Journal Article
- From:
Chinese Journal of Orthopaedics
2001;21(4):238-244
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of absorbable gelatin sponge, chitosan and sodium hyaluronate(HA) on inhibition of postoperatively epidural scar formation in animal models with posterior discectomy and the concentrations of HA in the cerebral spinal fluid was also determined. Methods 96 Wistar rats older than 12 months were equally allocated into four groups. Each animal underwent a unilateral hemi-laminectomy and discectomy. Absorbable gelatin sponge, chitosan and HA were placed at the sites of surgery in three groups respectively. The fourth group undergone laminectomy and discectomy only, was served as control. At the time of 2,4, 8, 12 weeks postoperatively, 6 rats in each group were sacrificed for gross evaluation, histology and transmission electron microscope studies. The areas of epidural scar and spinal canal were measured by a computer image processor, and were compared statistically. The concentrations of HA in the cerebral spinal fluid in the HA groups and control groups were tested. Results The epidural scar areas in the chitosan and HA groups were significantly less than those in the control and absorbable gelatin sponge groups; no significant difference was found among the spinal canal areas of all the groups at different time phase; the compression and dislocation of the dura and spinal nerve roots and the discontinuity of the annulus fiber were observed in every group and time phase. The two cases with highest concentrations of HA were in the HA group at 2-week. Conclusion Chitosan and HA are able to inhibit the epidural scar formation after posterior discectomy. The healing of the annulus must be considered when evaluating the scar inhibition effects of materials. When the materials are placed in the epidural space, their effects on the central nervous system should be considered.
