Kirikkale University Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey.
Injury. 2011 Aug;42(8):778-81. doi: 10.1016/j.injury.2010.12.017. Epub 2011 Mar 9.
Long term results after surgical treatment of disc herniation have shown that epidural and/or peridural fibrosis formed during the healing process after surgical intervention. We conducted this experimental study to evaluation of the effectiveness of the bioresorbable barriers (ADCON-L and Seprafilm(®) Adhesion Barrier) on formation of the peridural fibrosis in rat model performed laminectomy.
Thirty-two male Wistar albino rats 250-350g body weight were distributed into three groups (CONTROL, AL group received ADCON-L; SAB group received Seprafilm(®) Adhesion Barrier). A dorsal laminectomy at L3, L4, L5 was performed, and then except those of the CONTROL group, the experimental material was left on the dura mater. Six weeks later spinal column of all rats was totally removed between the T10 and L5 levels, and peridural fibrosis, and dural adhesions were evaluated histologically and graded. The results were compared statistically by using the chi-square (χ(2)) test. Also three random regions were examined, and the fibroblast cells were counted. The fibroblast count results were statistically analysed by using the One-Way ANOVA test.
The variation of histopathological grades was statistically significant regarding the comparison of the all groups obtained from the χ(2) test (χ(2)=16.40; p=0.003). However, the variation in the mean values of the fibroblast count result was not statistically significant obtained from the One-Way ANOVA test (F=2.114; p>0.05).
Our study results suggest that Seprafilm(®) Adhesion Barrier and ADCON-L can be effective in reducing the prevalence of the postoperative peridural adhesions in rat laminectomy model. On the other hand, the fibroblast densities of the experimental groups were not different between groups. So, we could say that these materials can act as a foreign body in long term period in rat.
手术治疗椎间盘突出症的长期结果表明，在手术干预后的愈合过程中会形成硬膜外和/或硬膜外纤维化。我们进行这项实验研究是为了评估生物可吸收屏障（ADCON-L 和 Seprafilm(®) 粘连屏障）在大鼠模型中椎板切除术后硬膜外纤维化形成中的有效性。
32 只雄性 Wistar 白化大鼠，体重 250-350g，分为三组（对照组、AL 组接受 ADCON-L；SAB 组接受 Seprafilm(®) 粘连屏障）。在 L3、L4、L5 行背侧椎板切除术，然后除对照组外，将实验材料留在硬脑膜上。6 周后，在 T10 和 L5 水平之间完全取出所有大鼠的脊柱，并进行组织学评估和分级。用卡方（χ(2)）检验对结果进行统计学比较。还检查了三个随机区域，并计算成纤维细胞数。用单向方差分析（One-Way ANOVA）检验对成纤维细胞计数结果进行统计学分析。
卡方检验（χ(2)=16.40；p=0.003）比较各组的组织病理学分级变化具有统计学意义。然而，从 One-Way ANOVA 检验得到的成纤维细胞计数结果的平均值变化没有统计学意义（F=2.114；p>0.05）。
我们的研究结果表明，Seprafilm(®) 粘连屏障和 ADCON-L 可有效降低大鼠椎板切除术后硬膜外粘连的发生率。另一方面，实验组的成纤维细胞密度在组间无差异。因此，我们可以说这些材料在大鼠体内可以作为一种异物长期存在。
