Lee J-Y, Ebel H, Friese M, Schillinger G, Schröder R, Klug N
Department of Neurosurgery, University of Cologne, Cologne, Germany.
Minim Invasive Neurosurg. 2003 Apr;46(2):106-9. doi: 10.1055/s-2003-39335.
This animal experimental study was designed to examine the effects of TachoComb, a fixed combination of collagen with tissue adhesive, as an interposition membrane on the development of spinal epidural fibrosis in comparison to other hemostyptic materials. In 10 Wistar rats, four laminectomies were performed at lumbar and sacral vertebrae. Alternately, a piece of TachoComb, Spongostan, or Tabotamp was placed into each laminectomy site. One laminectomy site served as an empty control (n = 10). 8 weeks later, the animals were sacrificed, and the spinal column including surrounding muscle tissue was removed en bloc from each rat and fixed in formaldehyde. After decalcification and staining the specimens were graded by a neuropathologist in a blindfold test for severity of epidural fibrosis as "light-moderate" or "marked". Epidural scarring of variable density was seen in all laminectomy sites. Light epidural fibrosis, without any adhesion to dura, as only noted in cases after application of TachoComb (n = 4/10) and Spongostan (n = 1/10). All other slices showed marked epidural fibrosis with dura adherence regardless of the implanted material. Statistical analysis revealed significantly lower epidural fibrosis after application of TachoComb compared to all other groups (p < 0.05). In this series, TachoComb is more effective in reducing the epidural fibrosis than Spongostan, and Tabotamp. However, complete prevention of scar tissue formation was not achieved.
本动物实验研究旨在检验速即纱（一种胶原蛋白与组织粘合剂的固定组合）作为一种插入膜与其他止血材料相比，对脊髓硬膜外纤维化发展的影响。在10只Wistar大鼠身上，于腰椎和骶椎进行了4次椎板切除术。然后，将一片速即纱、明胶海绵或泰绫交替放置于每个椎板切除部位。一个椎板切除部位作为空白对照（n = 10）。8周后，处死动物，从每只大鼠身上整块取出包括周围肌肉组织的脊柱，并固定于甲醛中。脱钙和染色后，由一名神经病理学家在盲法测试中根据硬膜外纤维化的严重程度将标本评为“轻度 - 中度”或“重度”。在所有椎板切除部位均可见密度不同的硬膜外瘢痕形成。仅在应用速即纱（n = 4/10）和明胶海绵（n = 1/10）后的病例中观察到轻度硬膜外纤维化，且与硬脊膜无粘连。所有其他切片均显示重度硬膜外纤维化并伴有硬脊膜粘连，与植入材料无关。统计分析显示，与所有其他组相比，应用速即纱后硬膜外纤维化显著降低（p < 0.05）。在本系列研究中，速即纱在减少硬膜外纤维化方面比明胶海绵和泰绫更有效。然而，并未完全防止瘢痕组织形成。
