Dexamethasone-soaked gelatin sponges prevent epidural adhesion / 中国组织工程研究

ABSTRACT

BACKGROUND:Clinicaly, dexamethasone-soaked gelatin sponges that are placed around the nerve root and spinal dura mater in lumbar disc excision have achieved good results. OBJECTIVE: To understand the effect of dexamethasone-soaked gelatin sponges in prevention of epidural adhesion in animals. METHODS:Forty New Zealand white rabbits were randomly divided into four groups folowed by removal of L4, L7 laminae, and a 1.0 cm×0.5 cm lamina dura area was exposed in each group. Then, the dura and nerve root were covered with dexamethasone-soaked gelatin sponges, dexamethasone, gelatin sponge and nothing (blank group), respectively. At 2, 4, 6, 8, 12 weeks after surgery, the entire operated vertebral segment and its accessories and paraspinal muscles were taken for gross and microscopic observation of nerve root and dural tissue adhesions. RESULTS AND CONCLUSION:At 12 weeks postoperatively, new bone tissue formed generaly at the site of laminectomy defect in the dexamethasone-soaked gelatin sponge group, with separable yelow-white membranous tissue around the dura; histological results showed the complete structure of fat cels, clearly distinct from the dura; there was no scar cel formation, no adhesions, no trabecular bone cartilage cels and hyperplasia. In the other three groups, a large number of peripheral epidural scar tissues were generaly seen, epidural adhesions were serious that could not be separated bluntly, and histological results showed colagenization of granulation tissue, dural thickening and serious adhesions. The findings indicate that dexamethasone-soaked gelatin sponges can synergisticaly prevent epidural adhesions.