[An experimental study on prevention of peridural adhesion after laminectomy].
OBJECTIVE
To explore effective substances and methods for prevention of peridural adhesion.


METHODS
Laminectomy was performed on the 5th lumbar segment in 64 rabbits, which were equally divided into 4 groups. The dura mater (12 mm x 6 mm) was exposed. The exposed dura mater was left uncovered in Group A; the exposed dura mater was covered with sodium hyaluronate jel (high molecular weight, 1 ml) in Group B; the lamina repair was performed with the autologous spinous process in Group C; the lamina repair was performed with the sodium hyaluronate jel filling and the autologous spinous process in Group D. The specimens were observed grossly and histologically at 2, 4, 6 and 8 weeks postoperatively. The computed imaging analysis on the epidural adhesion was also performed at 6 weeks postoperatively.


RESULTS
1) The gross anatomical evaluation: Severe peridural adhesion was formed in Group A, less adhesion formed in Groups B and C, but no obvious adhesion formed in Group D. 2) The area percentage of the epidural scar: The area percentage of the epidural scar was 15.89%+/-1.88% and 13.94%+/-1.89% in Groups C and D respectively, which were significantly lower than those in Groups A and B (22.66%+/-2.89% and 20.70%+/-2.82%, P<0. 05). 3) The density of epidural scar: The density of the epidural scars were 42.03%+/-7.36% and 36. 50+/-9.08% in Groups B and D, which were significantly lower than those in Groups A and C (63.73%+/-6.06% and 52. 11%+/- 4.10%, P< 0.05).


CONCLUSIONS
The high molecular weight sodium hyaluronate jel filling combined with the lamina repair using the autologous spinous process has the best preventive effect on the peridural adhesion after laminectomy.
Pang
Zucai
Z
Department of Orthopedics, Shunde Hospital of Integrated Tradional and Western Medicine, Foshan Guangdong, 528333, PR China. pangzc-2001@sohu.com.cn
Xu
Hanqun
H
Xie
Weijian
W
D000818:Animals; D004195:Disease Models, Animal; D007796:Laminectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D013118:Spinal Cord Diseases / Q000209:etiology / Q000517:prevention & control*; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control