Tao H, Wang Q, Lu R
Institute of Orthopaedics, Xijing Hospital, Forth Military Medical University.
Zhonghua Wai Ke Za Zhi. 1996 Jun;34(6):344-7.
Four biomaterials including pork fat (PF), glutaradehyde crosslinked pork peritonium (GCP), glutaradehyde cross-linked human amnion (GCA) and freeze-dried human amnion (FDA) dura were compared for their ability to prevent the dura from adhesion in 24 dogs. Noncontiguous laminectomies were performed on each dog. Laminectomized areas where the above mentioned 4 materials put randomly were served as experimental groups while laminectomized areas with autologous fat transplants put in place were served as standard control and empty control was set with the area left untreated. The formation of fibrosis and the adhesion of the dura were evaluated at 1, 2, 3, 4, 6, 12 weeks after operation by using a double-blind protocol. Methods of observation included gross anatomical evaluation, histological evaluation, computer-assisted image analysis, fibroblasts counting and measurement of SCEP. The results showed: 1. The epidural scar arose from the raw surface of erector spinal muscles and the bony edges created by the procedure; 2. Putting a suitable obstructor between the dura and the erector spinae muscle would make dura be exempted from adhesion; 3. The interpositional membrane should be tucked in between the bony edges in close proximity to the bony surface without leaving any room; 4. GCA seems to be efficient in preventing dural adhesion and reducing the invasion of the scar tissue in the spinal canal.
在24只犬中比较了4种生物材料（包括猪脂肪（PF）、戊二醛交联猪腹膜（GCP）、戊二醛交联人羊膜（GCA）和冻干人羊膜（FDA）硬脑膜）预防硬脑膜粘连的能力。对每只犬进行非连续性椎板切除术。将上述4种材料随机放置的椎板切除区域作为实验组，将自体脂肪移植的椎板切除区域作为标准对照，未处理的区域作为空白对照。采用双盲方案在术后1、2、3、4、6、12周评估纤维化形成和硬脑膜粘连情况。观察方法包括大体解剖评估、组织学评估、计算机辅助图像分析、成纤维细胞计数和SCEP测量。结果显示：1.硬膜外瘢痕源于竖脊肌的创面和手术造成的骨边缘；2.在硬脑膜和竖脊肌之间放置合适的阻挡物可使硬脑膜免于粘连；3.置入膜应紧贴骨表面夹在骨边缘之间，不留任何空隙；4.GCA似乎在预防硬脑膜粘连和减少瘢痕组织侵入椎管方面有效。
