[Experimental study on the polylactic acid glue in preventing epidural adhesion].
OBJECTIVE
To determine the ability of the polylactic acid glue (PLA-G) in preventing epidural adhesion after laminectomy.


METHODS
Each of the 24 randomly selected rats was done laminectomy of L2 and L5. The PLA-G, which would change from liquid to solid when meets with serum, was used in the epidural site of L5 to become a half-solid membrane (the experimental group, EG). The PLA-G was not used in the same site of L2 (the control group, CG). The gross anatomical, histological, and microscopical evaluation were made 2, 4, 6, 8, 10 and 12 weeks after operation; electron microscope observation was also made on two rats 4 weeks after operation(both EG and CG).


RESULTS
Obvious epidural space was observed between dura mater and scar tissue (ST), but no cells in the epidural space were observed in EG 2 weeks after operation. Corps of the red cells between dura mater and ST and proliferation of fibroblast cell (FB) were observed in CG 2 weeks after operation. Some remaining glue shivered in the epidural space with lightly increasing fibroblast and smooth dura mater were observed in EG 4 weeks after operation. However, fragile scar adhered with dura mater diffusely and more FB were observed in CG. From the 6th week to the 12th week, a potential interspace between scar and dura mater was observed and PLA glue was absorbed completely in EG. However, tougher scar, which was very difficult to dissect from dura mater and surrounding tissues, was observed. According to the fibroblast ultrastructure observation, bigger nucleus and more plentiful rough endoplasmic reticulum were observed in CG.


CONCLUSIONS
The PLA-G can effectively reduce the epidural scar and adhesion in animal experiment.
Liu
Limin
L
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan 610041, P R China. liulimin3030@sohu.com
Song
Yueming
Y
Duan
Hong
H
Ding
Yongli
Y
Lu
Bing
B
D000269:Adhesives; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D004824:Epidural Space; D005260:Female; D005347:Fibroblasts / Q000473:pathology / Q000648:ultrastructure; D019344:Lactic Acid / Q000627:therapeutic use*; D007796:Laminectomy / Q000009:adverse effects; D008297:Male; D046529:Microscopy, Electron, Transmission; D011091:Polyesters; D011108:Polymers / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D011817:Rabbits; D011897:Random Allocation; D051381:Rats; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*
D000269:Adhesives; D001672:Biocompatible Materials; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)