Effectiveness of the biophysical barriers on the peridural fibrosis of a postlaminectomy rat model: An experimental research

Kasımcan, Mustafa Ömür; Bakar, Bülent; Aktaş, Savaş; Alhan, Aslıhan; Yılmaz, Mustafa

doi:10.1016/j.injury.2010.12.017

Cited by 50 publications

(47 citation statements)

References 9 publications

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“…It must be kept in mind that some case reports have stated increased risk of CSF leakage after the use of Adcon ® Gel (9,16,18). Although discussions continue on whether Adcon ® Gel reduces scar formation and adhesions, neurosurgeons frequently use Adcon ® Gel during recurrent spine surgery to reduce peridural scarring and adhesions (13,17,27).…”

Section: Adconmentioning

confidence: 99%

To what extent topical application of cova™ and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

Kazanci¹,

Gurcan²,

Gürçay³

et al. 2016

Turkish Neurosurgery

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Section: Adconmentioning

confidence: 99%

To what extent topical application of cova™ and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

Kazanci¹,

Gurcan²,

Gürçay³

et al. 2016

Turkish Neurosurgery

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“…21 In our study, a model of laminectomy and discectomy (annular fenestration) was constructed, using 12-week-old female Sprague-Dawley rats weighing 250-300 g, to assess the relevance of this model compared with other studies.…”

mentioning

confidence: 99%

Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study

Işık

Taşkapılıoğlu²,

Atalay³

et al. 2015

SPI

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OBJECT Epidural fibrosis is nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in the intimate vicinity of and around the origin of the radicular sheath. The formation of dense fibrous tissue causes lumbar and radicular pain. In addition to radicular symptoms, the formation of scar tissue may cause problems during reoperation. The authors aimed to investigate the effects of cross-linked high-molecular-weight hyaluronic acid (HA), an HA derivative known as HA gel, on the prevention of epidural fibrosis by using histopathological and biochemical parameters. METHODS Fifty-six adult female Sprague-Dawley rats were evaluated. The rats were divided into 4 groups. Rats in the sham group (n = 14) underwent laminectomy and discectomy and received no treatment; rats in the control group (n = 14) underwent laminectomy and discectomy and received 0.9% NaCl treatment in the surgical area; rats in the HA group (n = 14) received HA treatment at the surgical area after laminectomy and discectomy; and rats in the HA gel group (n = 14) underwent laminectomy and discectomy in addition to receiving treatment with cross-linked high-molecular-weight HA in the surgical area. All rats were decapitated after 4 weeks, and the specimens were evaluated histopathologically and biochemically. The results were statistically compared using the Mann-Whitney U-test. RESULTS Compared with the sham and control groups, the HA and HA gel groups showed significantly lower fibroblast cell density and tissue hydroxyproline concentrations (p < 0.05). There was statistically significant lower dural adhesion and foreign-body reaction between the control and HA gel groups (p < 0.05). Granulation tissue and epidural fibrosis were significantly lower in the HA and HA gel groups compared with the sham group (p < 0.05). There were no significant differences in any histopathological parameters or biochemical values between Groups 3 and 4 (p > 0.05). CONCLUSIONS Cross-linked high-molecular-weight HA had positive effects on the prevention of epidural fibrosis and the reduction of fibrotic tissue density. The efficacy of this agent should also be verified in further experimental and clinical studies.

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“…Blocking the migration of fibroblasts to the surgical field is a theoretically applicable measure to prevent peridural fibrosis. However, when Kasimcan et al, [7] evaluated the number of fibroblasts between treatment and control groups, they found no significant difference in the amount of fibroblasts. In our study, there were significantly fewer fibroblasts in the treatment group than in the control group.…”

Section: Discussionmentioning

confidence: 95%

“…Many materials reportedly have the potential to prevent postoperative peridural adhesion or fibrosis, including physical materials such as barrier gels, Silastic ® sheets (Dow Corning Corp., Midland, MI, USA), and absorbable foams, chemical materials such as nonsteroid anti-inflammatory drugs (NSAIDs), pharmaceuticals, and steroids, and biologic materials such as hyaluronate membranes, cellulose mesh, and free and pedicle fat grafts. [5][6][7][8][9][10] However, the effects of these methods and materials remain questionable due to several extraneous and confounding variables in the experimental designs and various anti-adhesive agents.…”

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

Anti-adhesive effect of hyaluronate in a rabbit laminectomy model

Chen¹,

Lee²,

Tsai³

et al. 2014

Biomed J

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P ostoperative fibrosis after spinal surgeries such as discectomy and laminectomy can sometimes cause neurologic side effects due to direct compression of the nerves by the surrounding structures or by the formation of adhesion between tissues, tethering the nerve roots and dural sac. Previous studies have investigated the close Original Article At a Glance Commentary Scientific background of the subjectHyaluronic acid has been widely used in numerous clinical applications. It has been used to treat knee osteoarthritis by injecting it into the joint. It can act as an anti-adhesion barrier in preventing postoperative scar tissue formation in various surgical procedures such as myomectomy and laparotomy. What this study adds to the fieldHyaluronic acid-based gel is effective in decreasing the tenacity of adhesion between the dura and scar and the amount of scar tissues after laminectomy in a rabbit model, which can be considered as a potential anti-adhesion barrier in preventing postoperative adhesion formation.Background: Postlaminectomy dural adhesion is a common cause of recurrent symptoms. Hyaluronic acid-based gel has been reported to reduce the incidence of postoperative adhesion in the peritoneal cavity; however, its effect on preventing postoperative scar formation at laminectomy sites is not yet known. The purpose of this study was to evaluate the anti-adhesive effect of hyaluronic acid-based gelatin after laminectomy, using a rabbit model. Methods:Twelve adult New Zealand rabbits underwent two-level lumbar laminectomy, and were randomly assigned to one of two groups of six rabbits each. The treatment group received hyaluronic acid-based gelatin treatment and the control group was untreated. Rabbits were sacrificed 8 weeks after treatment. Peel-off testing and histological analysis were performed to assess the tenacity and the extent of adhesion formation. Results:No significant difference was observed in the neurologic performance between the two groups. The tenacity in the treatment group was significantly reduced compared to that of the control group (3.17 ± 0.75 vs. 4.33 ± 0.52, respectively; p = 0.016). Histological analysis showed significantly less scar tissue formation in the treatment group, with a larger subarachnoid space and greater distance between the dura and scar tissues. The amount of fibroblast cells also was significantly smaller in the treatment group than in the control group (3078 ± 313.68 vs. 3742 ± 455.65, respectively; p = 0.042). Conclusions: No serious adverse events were reported, and no difference was found in the incidence of complications between the treatment and control groups. The findings suggested that hyaluronic acid-based gelatin may be effective for preventing postlaminectomy dural adhesion in rabbits. (Biomed J 2014;37:218-224)

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Effectiveness of the biophysical barriers on the peridural fibrosis of a postlaminectomy rat model: An experimental research

Cited by 50 publications

References 9 publications

To what extent topical application of cova™ and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

To what extent topical application of cova™ and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study

Anti-adhesive effect of hyaluronate in a rabbit laminectomy model

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Effectiveness of the biophysical barriers on the peridural fibrosis of a postlaminectomy rat model: An experimental research

Cited by 50 publications

References 9 publications

To what extent topical application of cova&#8482; and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

To what extent topical application of cova&#8482; and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study

Anti-adhesive effect of hyaluronate in a rabbit laminectomy model

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To what extent topical application of cova™ and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.

To what extent topical application of cova™ and tisseel® cause spinal peridural fibrosis? comparison with adcon® gel: an experimental study in rat model.