Reduction of peridural fibrosis after lumbar laminotomy and discectomy in dogs by a resorbable gel (ADCON-L).
METHODS
A canine lumbar laminotomy and discectomy model was used to evaluate the effects of a resorbable gel, ADCON-L (Gliatech Inc., Cleveland, OH), in reducing peridural scar formation and to assess the healing progress of immediately adjacent normal structures.


OBJECTIVE
To compare peridural scar formation and anulus fibrosis healing with and without the use of ADCON-L in an animal model that closely replicates the common human surgical procedure.


BACKGROUND
ADCON-L has been shown to reduce the development of peridural scars in rat, rabbit, and canine laminectomy models in previous investigations; discectomies were not performed in these previous studies, however, and thus anular healing could not be assessed.


METHODS
Seven adult mongrel dogs underwent a three-level unilateral lumbar hemilaminotomy and anular fenestration. In each dog, the ADCON-L was applied to two randomly assigned sites around the discectomy, the nerve roots, and the hemilaminotomy. The third site underwent surgery, but was left untreated (sham surgery only). The canines were killed 8 weeks after surgery, and a gross anatomic assessment of scar formation was done using microdissection by an observer blinded to treatment. A numerical rating system was developed to assess the relative amount and tenacity of the anterior scarring (discectomy site) and posterior scarring (hemilaminotomy site). The healing of the anular defect was assessed histologically.


RESULTS
ADCON-L significantly reduced peridural fibrosis in this lumbar discectomy model compared with the sham treated sites (p < 0.05). Further, the superficial layers, the posterior longitudinal ligament, and the anulus fibrosus healed well in the ADCON-L treated sites.


CONCLUSIONS
ADCON-L reduced local peridural fibrosis after lumbar laminotomy and discectomy without impacting the healing of the surrounding tissues.
Einhaus
S L
SL
Department of Neurosurgery, University of Tennessee, Memphis, USA.
Robertson
J T
JT
Dohan
F C
FC
Wujek
J R
JR
Ahmad
S
S
D000818:Animals; D002921:Cicatrix / Q000188:drug therapy; D004195:Disease Models, Animal; D017586:Diskectomy / Q000009:adverse effects*; D004285:Dogs; D004388:Dura Mater / Q000187:drug effects / Q000473:pathology*; D005355:Fibrosis; D005782:Gels / Q000627:therapeutic use*; D007403:Intervertebral Disc / Q000473:pathology / Q000601:surgery; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D009930:Organic Chemicals; D011183:Postoperative Complications / Q000188:drug therapy; D013122:Spinal Diseases / Q000188:drug therapy* / Q000473:pathology; D014945:Wound Healing
C104199:ADCON-L; D005782:Gels; D009930:Organic Chemicals