The Effect of Barrier Gel and Free Fat Graft on the Formation of Epidural Fibrosis in the Laminectomy Model

Sami Engin, A. Akbaş, Volkan Kizilkaya
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Abstract

Introduction: This study aims to compare the efficacy of ADCON-L and free fat graft used to prevent epidural fibrosis in the experimental laminectomy model in rabbits. Materials and Methods: Thirty adult male New Zealand-type white rabbits weighing 2500-3000 grams were used. Three groups of ten were formed. New subjects and all subjects who replaced subjects who died during the study and follow-up period were sacrificed at the end of the 12th week. Group 1 was determined as the control group. Free fat grafts were placed into the laminectomy areas in group 2. In group 3, ADCON-L was injected into the surgical area. Subjects were sacrificed at week 12. After decalcification, laminectomy zones were taken into routine tissue follow-up for histopathological examination. Results: When group-1 and group-3 were compared regarding fibroblastic proliferation, there was a statistically significant difference (p<0.001). When group-2 and group-3 were compared, it was determined that fibroblastic proliferation was statistically higher in group-2 (p<0.001). When group-1 and group-3 were compared in terms of collagen amount, the amount of collagen in group-3 was significantly less (p<0.001). When the groups were evaluated statistically regarding the adhesion of the scar tissue to the dura, there was a significant difference between group-1 and group-2 (p<0.01). Adhesion was significantly less in group-3 compared to group-2 (p<0.001). Conclusion: We concluded that ADCON-L did not cause FBS syndrome. So, ADCON-L is more successful than free fat graft in the prevention of epidural fibrosis after laminectomy in spinal surgery.
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屏障凝胶和游离脂肪移植对椎板切除术模型硬膜外纤维化形成的影响
前言:本研究旨在比较ADCON-L和游离脂肪移植预防兔实验性椎板切除术模型硬膜外纤维化的效果。材料与方法:选用成年雄性新西兰型大白兔30只,体重2500 ~ 3000克。形成了三组,每组10人。在第12周结束时,新受试者和所有替代在研究和随访期间死亡受试者的受试者均被牺牲。第1组为对照组。第二组将游离脂肪移植物置于椎板切除区。第三组在手术区注射ADCON-L。受试者于第12周被处死。脱钙化后,椎板切除术区常规组织随访进行组织病理学检查。结果:1组与3组在成纤维细胞增殖方面比较,差异有统计学意义(p<0.001)。2组与3组比较,2组成纤维细胞增殖明显高于3组(p<0.001)。对比1组和3组的胶原蛋白含量,3组的胶原蛋白含量显著低于1组(p<0.001)。两组间疤痕组织与硬脑膜粘连情况比较,1组与2组间差异有统计学意义(p<0.01)。3组粘连明显低于2组(p<0.001)。结论:ADCON-L不会引起FBS综合征。因此,在预防脊柱手术椎板切除术后硬膜外纤维化方面,ADCON-L比游离脂肪移植更成功。
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