Comparison of the effects of an adhesion barrier and chitin on experimental epidural fibrosis.
OBJECTIVE
Epidural fibrosis is an important factor for postoperative failed back syndrome development and causes clinical complaints in 6-25% of cases. An effective treatment modality has not been found yet. The aim of this study is to investigate the anti-adhesive effects of a novel agent chitin and compare these effects with a popular adhesion barrier collagen matrix.


METHODS
21 rabbits were allocated into three groups including 7 rabbits each. L5 total laminectomy was performed to all groups. No treatment was given to Group 1 (Control group). Collagen matrix was used in Group 2 and chitin was used in Group 3. Six weeks later all rabbits were sacrificed and the laminectomy areas were entirely resected and investigated histopathologically.


RESULTS
He and Revel grade III epidural fibrosis was detected in the control group. Statistically significant reduction of epidural fibrosis was achieved with both of the anti-adhesive agents, collagen matrix and chitin, when compared with the control group (p < 0.05). The results were not different between treatment groups (p > 0.05).


CONCLUSIONS
The novel agent chitin was found effective for preventing epidural fibrosis and this effect was not significantly different from the collagen matrix. In light of our findings we suggest that chitin is an effective alternative for adhesion barriers.
Keskın
Fatih
F
Karaman State Hospital, Department of Neurosurgery, Karaman, Turkey. drfatihk@yahoo.com
Esen
Hasan
H
D000818:Animals; D002686:Chitin / Q000494:pharmacology*; D004195:Disease Models, Animal; D004824:Epidural Space / Q000187:drug effects* / Q000473:pathology; D055111:Failed Back Surgery Syndrome / Q000188:drug therapy* / Q000473:pathology; D005355:Fibrosis; D007796:Laminectomy / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy* / Q000473:pathology; D011817:Rabbits; D000267:Tissue Adhesions / Q000188:drug therapy* / Q000473:pathology
D002686:Chitin