[Experimental study on the prevention of epidural scar adhesion with polycaprolactone/polylactic acid membrane].
OBJECTIVE
To evaluate the ability of a polycaprolactone/polylactic acid (PCL/PLA) membrane to inhibit epidural scar adhesion after laminectomy, and observe the responsive changes of the pain media in the spinal cord.


METHODS
L(1), L(3) laminectomies were performed on 96 Wistar rats. The rats were divided into 3 groups: None-implant Control Group (NC), Autologous free fat graft group (AFFG) and PCL/PLA membrane group (PCL/PLAm). The rats were killed at 1, 3, 6, and 12 weeks postoperatively. Epidural scar formation and adhesion were observed grossly and histologically. Reverse transcription polymerase chain reaction (RT-PCR) were used to analyses the expression of Transforming growth factor beta (TGF-beta) in the epidural scar. Immunohistochemistry stain and RT-PCR were performed to evaluate the expression of the substance P and the c-fos gene in the relevant spinal cord, and the results were analyzed statistically.


RESULTS
Gross evaluation and histological evaluation showed that in the NC lamina defect site had much scar tissue and had wide and tight adhesions to the dura; in the AFFG, with the fat degrading gradually, the adhesions were increased; whereas in the PCL/PLAm group, there were slightly adhesions to the dura. RT-PCR showed that the expression of the TGF-beta was much less in the PCL/PLAm group than in the NC group. The insertion of the PCL/PLA membrane and the fat patch reduced the expression of the substance P and the c-fos gene in the spinal cord.


CONCLUSIONS
The insertion of the PCL/PLA membrane reduces scar formation and separates fibrosis tissue from the dura, the results indicate that PCL/PLA membrane is an effective way of reducing peridural scar formation and preventing the failed back surgery syndrome.
Zhang
Zhong-Wen
ZW
Department of Orthopaedics, The General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China.
Xu
Xin-Xiang
XX
Yang
Chuan-Duo
CD
Pang
Xiao-Dong
XD
Ji
Hui-Ru
HR
Yan
Jing-Jun
JJ
Zhu
Dong
D
Xiao
Guang
G
Yu
Dong-Hong
DH
D000818:Animals; D001672:Biocompatible Materials; D002921:Cicatrix / Q000517:prevention & control*; D005260:Female; D019344:Lactic Acid; D007796:Laminectomy / Q000009:adverse effects; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D011183:Postoperative Complications / Q000517:prevention & control; D019919:Prosthesis Implantation; D016760:Proto-Oncogene Proteins c-fos / Q000096:biosynthesis; D051381:Rats; D017208:Rats, Wistar; D013116:Spinal Cord / Q000378:metabolism; D013122:Spinal Diseases / Q000517:prevention & control*; D013373:Substance P / Q000096:biosynthesis; D000267:Tissue Adhesions / Q000517:prevention & control
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D016760:Proto-Oncogene Proteins c-fos; C016240:polycaprolactone; D013373:Substance P; D019344:Lactic Acid; C033616:poly(lactide)