Lee C K, Alexander H
Spine (Phila Pa 1976). 1984 Apr;9(3):305-12. doi: 10.1097/00007632-198404000-00016.
An animal experimental study was performed to investigate prevention of scar formation under lumbar laminectomy by using new biodegradable interposing materials-- polylactic acid (PLA) foam and membrane. The experimental animals consisted of 32 dogs, 16 control and 16 experimental. The experimental surgery consisted of L5 or L6 complete laminectomy and covering of the laminectomy defect with the experimental materials. The same procedure but without the covering of the laminectomy defect was performed on the control group animals. Animals were sacrificed at varying intervals (2-52 weeks) and the lumbar spines were evaluated with histologic preparations. The PLA membrane is found to be a promising material for prevention of scar tissue extension and adhesion after laminectomy but has a problem of marginal fitting. PLA foam is found to behave as a scaffold for scar tissue extension and adhesion onto the nerve. Other foamy materials such as gelatin foam or avitane are probably behaving similarly, causing scar tissue extension and adhesion. The new materials were found to be completely biocompatible and slowly biodegradable. A combined use of posteriorly convexed stiff PLA membrane and marginal gap filler with PLA foam may provide solutions for both prevention of scar tissue extension and adhesion and prevention of postlaminectomy spinal stenosis.
进行了一项动物实验研究，以探讨使用新型可生物降解的插入材料——聚乳酸（PLA）泡沫和膜来预防腰椎椎板切除术后瘢痕形成。实验动物包括32只狗，16只为对照组，16只为实验组。实验手术包括L5或L6全椎板切除术，并用实验材料覆盖椎板切除缺损处。对照组动物进行相同手术，但不覆盖椎板切除缺损处。在不同时间间隔（2至52周）处死动物，并用组织学标本评估腰椎。发现PLA膜是预防椎板切除术后瘢痕组织延伸和粘连的一种有前景的材料，但存在边缘贴合问题。发现PLA泡沫可作为瘢痕组织延伸并粘连到神经上的支架。其他泡沫材料如明胶海绵或阿维坦可能也有类似表现，导致瘢痕组织延伸和粘连。发现这些新材料具有完全的生物相容性且可缓慢生物降解。联合使用后凸的硬质PLA膜和PLA泡沫作为边缘间隙填充物，可能为预防瘢痕组织延伸和粘连以及预防椎板切除术后脊柱狭窄提供解决方案。
