de Tribolet N, Robertson J T
Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Eur Spine J. 1996;5 Suppl 1:S18-20. doi: 10.1007/BF00298568.
This case study focused on findings in two patients who underwent repeat discectomy following reherniation.
The cases are presented to show that use of ADCON-L Anti-Adhesion Barrier Gel can limit the extent of peridural adhesions subsequent to discectomy. Peridural fibrosis has been implicated as one of the principal causes of failed back surgery syndrome following lumbar discectomy.
Accurate assessment of the extent of scarring following lumbar discectomy has been made possible by the use of MR1; however, the only direct means of assessing adhesions is during reoperations to treat reherniations or other causes of surgical failure.
Both of the initial operations were performed using standard microsurgical procedures. At the end of surgery, one patient received ADCON-L Anti-Adhesion Barrier Gel and the other did not.
During the repeat operation, extensive peridural adhesions were found in the patient who did not receive ADCON-L during the initial discectomy procedure. In contrast, essentially neither scar nor adhesions were found in the patient who received ADCON-L.
ADCON-L effectively inhibits the development of peridural fibrosis following lumbar discectomy. This finding could have implications for the rate of occurrence of failed back surgery syndrome.
本病例研究聚焦于两名椎间盘再次突出后接受重复椎间盘切除术患者的研究结果。
展示使用ADCON-L抗粘连屏障凝胶可限制椎间盘切除术后硬膜外粘连的程度。硬膜外纤维化被认为是腰椎间盘切除术后腰椎手术失败综合征的主要原因之一。
使用磁共振成像(MRI)能够准确评估腰椎间盘切除术后的瘢痕形成程度;然而,评估粘连的唯一直接方法是在再次手术治疗再次突出或其他手术失败原因时进行。
最初的两台手术均采用标准显微外科手术操作。手术结束时,一名患者接受了ADCON-L抗粘连屏障凝胶,另一名患者未接受。
在重复手术过程中,最初椎间盘切除术中未接受ADCON-L的患者发现广泛的硬膜外粘连。相比之下,接受ADCON-L的患者基本未发现瘢痕或粘连。
ADCON-L可有效抑制腰椎间盘切除术后硬膜外纤维化的发展。这一发现可能对腰椎手术失败综合征的发生率产生影响。