Robertson J T, Meric A L, Dohan F C, Schweitzer J B, Wujek J R, Ahmad S
Department of Neurosurgery, University of Tennessee, Memphis.
J Neurosurg. 1993 Jul;79(1):89-95. doi: 10.3171/jns.1993.79.1.0089.
Spinal peridural fibrosis following total laminectomy in New Zealand White rabbits was significantly decreased by the intraoperative application of GT1587, a semi-synthetic carbohydrate polymer. The application of a similar polymer, GT1043, or phosphate-buffered saline (PBS) was not as effective. Laminectomies were performed at L-2 and L-4 in 25 rabbits. Absorbable gelatin sponge soaked with GT1043, GT1587, or PBS was applied in a blinded fashion to the operative sites, with untreated (sham) laminectomy sites serving as controls. Animals were sacrificed after 2 or 4 weeks. The extent of peridural fibrosis was evaluated by gross microdissection and histological analysis. Dense scar formation and dural adhesions were evident at both time intervals in the sham- and PBS-treated laminectomy sites. The sites treated with GT1587 showed significantly decreased peridural scar formation and dural adhesions, whereas GT1043 treatment caused modest reduction of scar formation at only the 2-week examination. The healing of skin and lumbosacral fascia was not affected by treatment of the laminectomy site with GT1587. These results suggest that GT1587 may prove beneficial in preventing postlaminectomy dural adhesions and peridural fibrosis in humans.
在新西兰白兔中,全椎板切除术后的脊柱硬膜外纤维化通过术中应用GT1587(一种半合成碳水化合物聚合物)显著减少。应用类似聚合物GT1043或磷酸盐缓冲盐水(PBS)的效果则不佳。对25只兔子在L-2和L-4节段进行椎板切除术。将浸有GT1043、GT1587或PBS的可吸收明胶海绵以盲法应用于手术部位,未处理(假手术)的椎板切除部位作为对照。在2周或4周后处死动物。通过大体显微解剖和组织学分析评估硬膜外纤维化的程度。在假手术和PBS处理的椎板切除部位,两个时间点均可见致密瘢痕形成和硬膜粘连。用GT1587处理的部位硬膜外瘢痕形成和硬膜粘连显著减少,而GT1043处理仅在2周检查时导致瘢痕形成有适度减少。GT1587处理椎板切除部位对皮肤和腰骶筋膜的愈合没有影响。这些结果表明,GT1587可能对预防人类椎板切除术后硬膜粘连和硬膜外纤维化有益。