Prevention of anterior scar formation following discectomy with a medishield adhesion barrier: randomized experimental trial

Sucu, Hasan Kamil; Sevin, Ismail Ertan; Rezanko, Türkan; Hamdi, Bezircioglu; Sevin, Gülnur

doi:10.5137/1019-5149.jtn.6467-12.2

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…Several studies have shown that MediShield reduces dural adhesion formation and improves the symptoms of postlaminectomy syndrome. 19,31,35 Our results are in agreement with these studies, indicating that silk solution has a positive effect on the prevention of postlaminectomy dural adhesion formation.…”

Section: Discussionsupporting

confidence: 91%

Effects of silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model

Cho

Lee

Kim

et al. 2018

Journal of Neurosurgery: Spine

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OBJECTIVEAdhesion formation is one of the most common complications following laminectomy. The efficiency of antiadhesive agents is required to prevent postsurgical adhesion. Therefore, the authors investigated the effects of silk solution against laminectomy-induced dural adhesion formation in a rat model.METHODSThe authors prepared the silk solution from silkworms. Laminectomies were performed between L3 and L5 in all rats. MediShield was used as a control. The effects of silk solution against laminectomy-induced dural adhesion formation and inflammation were confirmed by histological examination and Western blot analysis.RESULTSLaminectomy-induced dural adhesion formation was drastically reduced in silk solution–treated rats (Grade 2) compared to vehicle-treated rats (Grade 3). Dural adhesion formation was significantly reduced in rats that received treatment with silk solution or MediShield, which is a known antiadhesion drug. In addition, combined treatment with silk solution and MediShield showed greater reductions in inflammation compared to the silk solution– or MediShield-treated rats (p > 0.05).CONCLUSIONSIn this study, the authors demonstrated that silk solution effectively reduced postlaminectomy dural adhesion formation in rats. Although further studies on the long-term effects are necessary to validate these results, silk solution may potentially serve as an antiadhesion agent in neurological procedures.

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Section: Discussionsupporting

confidence: 91%

Effects of silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model

Cho

Lee

Kim

et al. 2018

Journal of Neurosurgery: Spine

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“…At the same time, the spinal canal and the posterior column structure of vertebral body were reconstructed, providing attachment points for muscles on both sides. The biomechanical stability was strong, and the patients could move earlier after surgery [ 19 ]. Zhou et al reported that patients who underwent laminectomy replantation had a 36% to 60% increase in longitudinal spinal stress resistance and a 38% to 49% increase in lateral stability, compared with patients who underwent total laminectomy [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Total Laminectomy and Pedicle Screw Internal Fixation with Ultrasonic- and Microscopic-Assisted Laminectomy Replantation for Tumors of the Lumbar Spinal Canal: A Retrospective Study of 60 Cases from a Single Center

Duan

Miao

et al. 2021

Med Sci Monit

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Background Total laminectomy with pedicle screw internal fixation is the most common surgical procedure for patients with primary tumors arising in the spinal canal, but the procedure has several limitations. This study aimed to compare total laminectomy and pedicle screw internal fixation with ultrasound- and microscope-assisted laminectomy replantation surgery in patients with tumors of the lumbar spinal canal. Material/Methods A retrospective study was conducted. Sixty patients with tumor spinal canal were admitted to our hospital. Patients in group A (n=32) underwent total laminectomy and pedicle screw internal fixation; patients in group B (n=28) underwent laminectomy replantation with ultrasonic and microscopic assistance. Operative time, intraoperative blood loss, operative segment, length of hospital stay, postoperative length of bed rest, and visual analog scale (VAS) score after surgery were analyzed. Results Hospital stay and postoperative bed rest time of patients in group B were shorter than those in group A ( P =0.004). Intraoperative blood loss, postoperative drainage volume, and postoperative pain relief of group B were significantly lower than those of group A ( P =0.000). There was no significant difference in postoperative pathological results between the 2 groups ( P =0.901). Conclusions Ultrasound- and microscope-assisted laminectomy replantation resulted in the reduced intraoperative blood loss, postoperative drainage volume, length of hospital stay, and postoperative VAS pain score, compared with total laminectomy and pedicle screw internal fixation for the surgical removal of tumors of the lumbar spinal canal.

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“…The classification is based upon the opinion of the pathologist who rates the degree of epidural fibrous adherence. Sucu et al [ 23 ] found no validated histopathological grading system for epidural fibrosis. Therefore, the histopathological classification for postoperative epidural fibrosis experimental research should be validated and tested for its interrater reliability between the assessors who rate the postoperative epidural fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model

et al. 2015

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Study DesignAgreement study.PurposeTo validate the interrater reliability of the histopathological classification of the post-laminectomy epidural fibrosis in an animal model.Overview of LiteratureEpidural fibrosis is a common cause of failed back surgery syndrome. Many animal experiments have been developed to investigate the prevention of epidural fibrosis. One of the common outcome measurements is the epidural fibrous adherence grading, but the classification has not yet been validated.MethodsFive identical sets of histopathological digital files of L5-L6 laminectomized adult Sprague-Dawley rats, representing various degrees of postoperative epidural fibrous adherence were randomized and evaluated by five independent assessors masked to the study processes. Epidural fibrosis was rated as grade 0 (no fibrosis), grade 1 (thin fibrous band), grade 2 (continuous fibrous adherence for less than two-thirds of the laminectomy area), or grade 3 (large fibrotic tissue for more than two-thirds of the laminectomy area). A statistical analysis was performed.ResultsFour hundred slides were independently evaluated by each assessor. The percent agreement and intraclass correlation coefficient (ICC) between each pair of assessors varied from 73.5% to 81.3% and from 0.81 to 0.86, respectively. The overall ICC was 0.83 (95% confidence interval, 0.81-0.86).ConclusionsThe postoperative epidural fibrosis classification showed almost perfect agreement among the assessors. This classification can be used in research involving the histopathology of postoperative epidural fibrosis; for example, for the development of preventions of postoperative epidural fibrosis or treatment in an animal model.

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Prevention of anterior scar formation following discectomy with a medishield adhesion barrier: randomized experimental trial

Cited by 3 publications

References 24 publications

Effects of silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model

Effects of silk solution against laminectomy-induced dural adhesion formation and inflammation in a rat model

Comparison of Total Laminectomy and Pedicle Screw Internal Fixation with Ultrasonic- and Microscopic-Assisted Laminectomy Replantation for Tumors of the Lumbar Spinal Canal: A Retrospective Study of 60 Cases from a Single Center

Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model

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