Effects of hemostatic polysaccharide agent on epidural fibrosis formation after lumbar laminectomy in rats

详细信息    查看全文

• 作者：Selin Tural Emon ; MD^a ; ^{turalselin@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Hakan Somay ; MD^a ; Metin Orakdogen ; MD^a ; Serap Uslu ; PhD^b ; Adnan Somay ; MD^c
• 关键词：Epidural fibrosis ; Hemostatic polysaccharide ; Laminectomy ; Rat ; Spinal surgery ; Hemostasis
• 刊名：The Spine Journal
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：16
• 期：3
• 页码：414-419
• 全文大小：877 K

文摘

Epidural fibrosis is a common adverse outcome of spinal surgery that can compress the dural sac and nerve root. Local hemostatic agents have many indications in numerous types of spinal surgery. As these agents may behave as foreign bodies, inducing inflammation and delaying regeneration, they could enhance the risk of epidural fibrosis.

Purpose

We evaluated the effects of hemostatic polysaccharide on epidural fibrosis development in laminectomized rats.

Study Design

This is a randomized controlled trial.

Outcome Measures

One month after surgery, tissues were histopathologically examined. Spinal tissue surrounding the laminectomy site was cut with a microtome and stained with hematoxylin and eosin and Masson trichrome. Slides were evaluated by a pathologist in a blinded fashion. The extent of epidural fibrosis, fibroblast cell density, cartilage, and bone regeneration was evaluated.

Methods

Rats were randomly assigned to receive sham surgery, laminectomy, or laminectomy with hemostatic polysaccharide (seven rats per group). Sham surgery that consisted of a skin incision was performed without laminectomy. Laminectomy was performed at the L1 and L2 vertebrae. In the experimental group, the polysaccharide hemostatic material, HaemoCer was placed in the laminectomy area.

Results

The proportion of rats with epidural fibrosis in laminectomized mice (both with and without hemostatic material) was higher than in sham-operated rats (p<.01). There was no difference in fibrosis between the two groups of laminectomized rats (p>.05).

Conclusions

Our study indicates that hemostatic polysaccharide does not enhance epidural fibrosis following laminectomy in rodents, suggesting that absorbable polysaccharides may be appropriate for use in hemostasis during spinal surgery.