腰椎间盘手术后的硬膜外瘢痕形成：有无自体游离脂肪移植的等效瘢痕形成。
Epidural scarring after lumbar disc surgery: Equivalent scarring with/without free autologous fat grafts.
作者信息
Dobran M, Brancorsini D, Costanza M Della, Liverotti V, Mancini F, Nasi D, Iacoangeli M, Scerrati M
机构信息
Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy.
Department of Pathological Anatomy, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy.
出版信息
Surg Neurol Int. 2017 Aug 1;8:169. doi: 10.4103/sni.sni_142_17. eCollection 2017.
BACKGROUND
To limit epidural fibrosis and prevent scar formation/nerve tethering that may contribute to chronic postoperative pain; some surgeons have utilized epidural autologous fat grafts following lumbar microdiscectomy.
METHODS
We investigated the correlation between post-microdiscectomy epidural scarring [including select magnetic resonance imaging (MRI) studies] and clinical outcomes in 36 patients operated for symptomatic. MRI documented L4-L5 and L5-S1 disk herniations with (18 patients) and without (18 patient) the application of free fat grafts. In addition, histological evaluation of the original fat grafts was performed in 4 patients requiring additional surgery.
RESULTS
We found no clear association between the use of autologous graft fats and the clinical outcomes in this study.
CONCLUSION
In this preliminary study involving only 36 patients, the prospective randomized use of free autologous fat grafts did not appear to influence outcomes following microdiscectomy.
背景
为限制硬膜外纤维化并防止可能导致慢性术后疼痛的瘢痕形成/神经粘连，一些外科医生在腰椎间盘显微切除术后使用了硬膜外自体脂肪移植。
方法
我们调查了36例因症状性病变接受手术的患者椎间盘显微切除术后硬膜外瘢痕形成（包括选择性磁共振成像（MRI）研究）与临床结果之间的相关性。MRI记录了18例应用游离脂肪移植和18例未应用游离脂肪移植的L4-L5和L5-S1椎间盘突出症。此外，对4例需要再次手术的患者的原始脂肪移植进行了组织学评估。
结果
在本研究中，我们未发现自体移植脂肪的使用与临床结果之间存在明确关联。
结论
在这项仅涉及36例患者的初步研究中，前瞻性随机使用游离自体脂肪移植似乎并未影响椎间盘显微切除术后的结果。
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