Yilmaz Murat, Gulabi Deniz, Guclu Bulent, Kaya Ibrahim, Basak Kayhan, Bas Ali
Haseki Research and Training Hospital, Orthopaedic and Traumatology Clinic, Istanbul, Turkey.
Turk Neurosurg. 2017;27(1):114-118. doi: 10.5137/1019-5149.JTN.14559-15.1.
Lumbar epidural fibrosis is increasingly recognized as a cause of persistent back pain. The aim of this study was to examine the effect Ankaferd Blood Stopper on epidural fibrosis following laminectomy in rat models.
Twenty Sprague-Dawley male rats were randomly allocated to 2 groups of 10 each. The dura mater and nerve root were exposed after L1 unilateral laminectomy. Close attention was paid not to traumatize the dura, the nerve roots, or the dissected muscles. Immediate muscle and skin closure was made in sham group. In the Ankaferd Blood Stopper group, cotton wool soaked with 1 mL Ankaferd Blood Stopper was applied to the exposure site for 5 minutes, and muscle and skin closure was then made. Histological analysis was performed at four weeks postoperatively.
Epidural fibrosis formation evaluation and fibroblastic activity evaluation revealed that there was a significant difference between the sham and the Ankaferd Blood Stopper treated groups (p = 0.011, p = 0.009). Severe epidural adhesions were observed in the Ankaferd Blood Stopper group. Dissection of these epidural adhesions was difficult and accompanied by bleeding and disruption of the dura mater.
The results of this study showed that there was no positive effect of Ankaferd Blood Stopper on the prevention of epidural fibrosis, which is one of the most significant problems following spinal surgery, and the epidural fibrosis actually increased.
腰椎硬膜外纤维化日益被认为是持续性背痛的一个原因。本研究的目的是在大鼠模型中检验安卡芬德止血剂对椎板切除术后硬膜外纤维化的影响。
20只雄性斯普拉格-道利大鼠被随机分为2组,每组10只。在L1单侧椎板切除术后暴露硬脑膜和神经根。密切注意避免损伤硬脑膜、神经根或切开的肌肉。假手术组立即缝合肌肉和皮肤。在安卡芬德止血剂组,将浸泡有1毫升安卡芬德止血剂的棉球敷于暴露部位5分钟,然后缝合肌肉和皮肤。术后四周进行组织学分析。
硬膜外纤维化形成评估和成纤维细胞活性评估显示,假手术组与安卡芬德止血剂治疗组之间存在显著差异(p = 0.011,p = 0.009)。在安卡芬德止血剂组观察到严重的硬膜外粘连。分离这些硬膜外粘连困难,伴有出血和硬脑膜破裂。
本研究结果表明,安卡芬德止血剂对预防硬膜外纤维化没有积极作用,硬膜外纤维化是脊柱手术后最严重的问题之一,实际上反而增加了。