ABSTRACT
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). CONCLUSION: 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.
