Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Acta Orthop Traumatol Turc. 2022 Jul;56(4):256-261. doi: 10.5152/j.aott.2022.21392.
This study aimed to compare the anti-epidural fibrosis and anti-inflammation effects of hyaluronic acid (HA)-carboxymethylcellulose (CMC)-alginate hydrogel, pure HA, and normal saline using a lumbar laminectomized rat model.
Thirty lumbar laminectomized adult rats were randomly assigned to three groups. The control group received normal saline, the HCA group received HA-CMC-alginate gel, and the HA group received pure HA gel soaked over the dura of the laminectomized area before closing the surgical wound. All rats were housed for eight weeks, then epidural fibrosis (EF) was histologically graded. In addition, the fibroblast and inflammatory cell density were computerized for evaluation.
The mean fibroblast densities were 32.03 × 102 ± 488, 13.22 × 102 ± 200, and 14.52 × 102 ± 368 cell/mm2 in the control, HCA, and HA groups, respectively. The mean inflammatory cell density was 30.74 × 102 ± 459, 5.90 × 102 ± 129, and 11.08 × 102 ± 282 cell/mm2 in the control, HCA, and HA groups, respectively. The mean fibroblast and inflammatory cell densities in the HCA and HA groups were significantly lower than in the control group (P < 0.05). The HCA group had a significantly lower inflammatory cell density than the HA group (P < 0.05). The fibrous adherence grading of HCA and HA was significantly lower than the control (P < 0.05).
HA-CMC-alginate gel and HA hydrogels seem to have a better preventative effect on EF than no treatment (control). HA-CMCalginate can exhibit a better anti-inflammatory effect than HA. HA-CMC-alginate can be effective in reducing EF and inflammation after lumbar laminectomy.
本研究旨在通过腰椎板切除术大鼠模型比较透明质酸（HA）-羧甲基纤维素（CMC）-藻酸盐水凝胶、纯 HA 与生理盐水的抗硬膜外纤维化和抗炎作用。
将 30 只腰椎板切除的成年大鼠随机分为三组。对照组给予生理盐水，HCA 组给予 HA-CMC-藻酸盐凝胶，HA 组在关闭手术切口前将 HA 凝胶浸泡在硬膜外切除区域。所有大鼠均饲养 8 周，然后对硬膜外纤维化（EF）进行组织学分级。此外，对成纤维细胞和炎症细胞密度进行计算机评估。
对照组、HCA 组和 HA 组的平均成纤维细胞密度分别为 32.03×102±488、13.22×102±200 和 14.52×102±368 个细胞/mm2。对照组、HCA 组和 HA 组的平均炎症细胞密度分别为 30.74×102±459、5.90×102±129 和 11.08×102±282 个细胞/mm2。HCA 组和 HA 组的平均成纤维细胞和炎症细胞密度明显低于对照组（P<0.05）。HCA 组的炎症细胞密度明显低于 HA 组（P<0.05）。HCA 组和 HA 组的纤维粘连分级明显低于对照组（P<0.05）。
HA-CMC-藻酸盐凝胶和 HA 水凝胶似乎比不治疗（对照组）对 EF 有更好的预防作用。HA-CMC-藻酸盐可以表现出比 HA 更好的抗炎作用。HA-CMC-藻酸盐在腰椎板切除术后可有效减少 EF 和炎症。
