title: Effects of hemostatic polysaccharide agent on epidural fibrosis formation after lumbar laminectomy in rats.
abstract: BACKGROUND
  Epidural fibrosis is a common adverse outcome of spinal surgery that can compress the dural sac and nerve root. Local hemostatic agents have many indications in numerous types of spinal surgery. As these agents may behave as foreign bodies, inducing inflammation and delaying regeneration, they could enhance the risk of epidural fibrosis.
  
  
  OBJECTIVE
  We evaluated the effects of hemostatic polysaccharide on epidural fibrosis development in laminectomized rats.
  
  
  METHODS
  This is a randomized controlled trial.
  
  
  METHODS
  One month after surgery, tissues were histopathologically examined. Spinal tissue surrounding the laminectomy site was cut with a microtome and stained with hematoxylin and eosin and Masson trichrome. Slides were evaluated by a pathologist in a blinded fashion. The extent of epidural fibrosis, fibroblast cell density, cartilage, and bone regeneration was evaluated.
  
  
  METHODS
  Rats were randomly assigned to receive sham surgery, laminectomy, or laminectomy with hemostatic polysaccharide (seven rats per group). Sham surgery that consisted of a skin incision was performed without laminectomy. Laminectomy was performed at the L1 and L2 vertebrae. In the experimental group, the polysaccharide hemostatic material, HaemoCer was placed in the laminectomy area.
  
  
  RESULTS
  The proportion of rats with epidural fibrosis in laminectomized mice (both with and without hemostatic material) was higher than in sham-operated rats (p<.01). There was no difference in fibrosis between the two groups of laminectomized rats (p>.05).
  
  
  CONCLUSIONS
  Our study indicates that hemostatic polysaccharide does not enhance epidural fibrosis following laminectomy in rodents, suggesting that absorbable polysaccharides may be appropriate for use in hemostasis during spinal surgery.
authors.affiliation: Department of Neurosurgery, Haydarpasa Numune Training and Research Hospital, Tibbiye Cad No: 40 Uskudar, 34668 Istanbul, Turkey. Electronic address: turalselin@gmail.com.
authors.forename: Selin
authors.initials: S
authors.lastname: Tural Emon
authors.affiliation: Department of Neurosurgery, Haydarpasa Numune Training and Research Hospital, Tibbiye Cad No: 40 Uskudar, 34668 Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Somay
authors.affiliation: Department of Neurosurgery, Haydarpasa Numune Training and Research Hospital, Tibbiye Cad No: 40 Uskudar, 34668 Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Orakdogen
authors.affiliation: Department of Histology and Embryology, Medeniyet University Medical School, Dr Erkin Cad Göztepe, 34722 Istanbul, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Uslu
authors.affiliation: Department of Pathology, Fatih Sultan Mehmet Training and Research Hospital, Icerenkoy, 34752 Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Somay
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects* / Q000473:pathology; D000818:Animals; D004388:Dura Mater / Q000187:drug effects* / Q000473:pathology; D004824:Epidural Space / Q000187:drug effects / Q000473:pathology; D005347:Fibroblasts / Q000166:cytology / Q000187:drug effects*; D005355:Fibrosis; D006490:Hemostatics / Q000494:pharmacology*; D007796:Laminectomy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D011134:Polysaccharides / Q000494:pharmacology*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D006490:Hemostatics; D011134:Polysaccharides
keywords: Epidural fibrosis; Hemostasis; Hemostatic polysaccharide; Laminectomy; Rat; Spinal surgery