A collagen-based sealant to prevent in vivo reformation of epidural scar adhesions in an adult rat laminectomy model.
OBJECTIVE
The authors investigated the effect of a collagen-based sealant, Gel Amidon Oxydé (GAO), in preventing the reformation of epidural scar adhesions in an adult rat model of laminectomy.


METHODS
Thirty-two adult Sprague-Dawley rats underwent a complete L5-6 laminectomy, after which the dura mater was exposed and the left adjacent L-4 and L-5 nerve roots were exposed. The surgical wound was then closed; 1 month later it was reopened. The epidural scar adhesions that developed were observed and carefully removed, leaving clean dura and nerve roots reexposed. In 16 experimental rats, GAO was placed onto the reexposed dura and around the nerve roots before it polymerized. No treatment was performed in 16 control rats. Postoperatively, all rats were healthy and without neurological deficit. The incisions healed within 1 week regardless of the treatment with the GAO. Three months after reoperation, magnetic resonance imaging revealed that important epidural adhesions were present in the control rats but not in the experimental rats. These findings were then confirmed by gross anatomical examination in which a white tissue layer was found over the dura without adhesions in the experimental animals, whereas significant epidural scar adhesions were demonstrated in the controls. Histological evaluation of the laminectomy site also showed that the peridural space in the experimental rats was larger than that in the controls.


CONCLUSIONS
The authors found that GAO may be a safe and effective antiscarring adhesion biomaterial in vivo. When placed into the laminectomy site, GAO may prove beneficial in preventing the formation and reformation of epidural scar adhesions in humans.
Department of Neurosurgery, Hospital of Bicêtre, Assistance Publique-Hĵpitaux de Paris, Le Kremlin Bicêtre, France. liusong986@hotmail.com
Song
S
Liu
Jean Pierre
JP
Boutrand
Jacques
J
Bittoun
Marc
M
Tadie
D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002921:Cicatrix / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D003094:Collagen / Q000627:therapeutic use*; D004824:Epidural Space / Q000473:pathology; D007796:Laminectomy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D051381:Rats; D017207:Rats, Sprague-Dawley; D055502:Secondary Prevention; D013122:Spinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000267:Tissue Adhesions / Q000175:diagnosis / Q000517:prevention & control*
D001672:Biocompatible Materials; C418362:collagen-based sealant GAO; D003094:Collagen