Abstract
Introduction. Epidural fibrosis is an urgent problem in modern spinal surgery and orthopedics. The formation of connective tissue in the epidural space after performing surgical interventions on the spinal column inevitably leads to adhesion of the latter to the dura mater and compression of neural structures, followed by the formation of clinical and neurological symptoms. The search for literary sources in domestic and foreign scientific databases has demonstrated the presence of several works studying the effectiveness of barrier methods for preventing the development of epidural fibrosis. It should be noted that the results of these studies are ambiguous and largely contradictory.The purpose was to study the effectiveness of using a spatially cross-linked polymer in the postoperative lumbar epidural fibrosis prevention in an experiment.Materials and methods. The study included 26 male Wistar rats (average body weight 338.5±9.07 g), which were divided into two groups: Group I (control, n = 12): animals underwent laminectomy at the level of vertebral bodies LVII – SI without application of spatially crosslinked polymer; Group II (experimental, n = 14): animals underwent laminectomy at the level of vertebral bodies LVII – SI followed by application of a spatially cross-linked polymer to the dura mater. The morphological and instrumental parameters were studied.Results. Significant differences were noted in the severity of epidural fibrosis (χ2 = 14.846, p = 0.003), the number of newly formed vessels (F = 14.371, p<0.001), the number of fibroblasts (F = 11.158, p<0.001), as well as in the severity of vertebral stenosis channe l according to multislice computed tomography (χ2 = 17.207, p=0.002) between the control and experimental groups of animals.Conclusion. Application of a spatially cross-linked polymer to the dura mater is an effective way to prevent the development of postoperative epidural fibrosis.
Highlights
Epidural fibrosis is an urgent problem in modern spinal surgery and orthopedics
The formation of connective tissue in the epidural space after performing surgical interventions on the spinal column inevitably leads to adhesion
foreign scientific databases has demonstrated the presence of several works studying the effectiveness of barrier methods
Summary
Крысы линии Wistar (аутбредные, белые, альбиносы) содержались в контролируемой окружающей среде при температуре 22–25 0С с соответствующим режимом влажности и 12‐часовым циклом свет / темнота. В исследование включено 26 самцов крыс линии Wistar (средняя масса тела составила 338,5 ± 9,07 г), которые разделены на две группы:. 1. Этапы выполнения экспериментального хирургического вмешательства: а – выполнена ламинэктомия, обнажена твердая мозговая оболочка, подготовлена пластинка пространственно-сшитого полимера «Реперен», б – пластинка пространственно-сшитого полимера «Реперен» апплицирована на твердую мозговую оболочку. – I группа (контрольная, n=12): животным выполнена операция ламинэктомии на уровне тел позвонков LVII – SI без аппликации пространственно-сшитого полимера с целью профилактики развития послеоперационного эпидурального фиброза;. – II группа (экспериментальная, n = 14): животным выполнена операция ламинэктомии на уровне тел позвонков LVII – SI с последующей аппликацией пространственно-сшитого полимера «Reperen» (IconLab Inc., Нижний Новгород, Россия) на твердую мозговую оболочку с целью профилактики развития послеоперационного эпидурального фиброза
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