Lack of postdiscectomy adhesions following application of ADCON-L: a case report.
METHODS
This case study focused on findings in two patients who underwent repeat discectomy following reherniation.


OBJECTIVE
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.


BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
N
N
de Tribolet
J T
JT
Robertson
D017586:Diskectomy; D004388:Dura Mater; D005260:Female; D005782:Gels / Q000627:therapeutic use*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008875:Middle Aged; D009930:Organic Chemicals; D011183:Postoperative Complications / Q000517:prevention & control*; D013118:Spinal Cord Diseases / Q000517:prevention & control; D000267:Tissue Adhesions / Q000517:prevention & control
C104199:ADCON-L; D005782:Gels; D009930:Organic Chemicals