Effect of platelet-rich fibrin on epidural fibrosis and comparison to ADCON® Gel and hyaluronic acid (original) (raw)
Related papers
2018
The aim of this study was to evaluate of the effect of 5% Polyethylene Glycol 4000 in the prevention of epidural fibrosis and to compare the results with hyaluronic acid. A total of 36 adult New Zealand White Rabbits were used in the study. Three groups were formed with each group including 12 rabbits (Group I: Control, Group II: 5% Polyethylene Glycol 4000, Group III: Hyaluronic acid). Hemilaminectomy was performed at L5 vertebrae on the right side. Three rabbits randomly selected from each group at postoperative 2nd, 4th, 8th and 12th week were euthanized. Macroscopic and histopathological evaluation were performed in terms of the amount of scar tissues. Statistical evaluation was made with Mann-Whitney U Test and Kruskal-Wallis Variance Analysis. P < 0.05 was considered statistically significant. In the hemilaminectomy sites of Group I, severe thickness and tenacious epidural scar adhesions were found between the dura mater and surrounding tissues. In the Group II, dura mater ...
Hemostasis vs. epidural fibrosis?: A comparative study on an experimental rat model of laminectomy
Neurologia i Neurochirurgia Polska, 2016
The aim of this study was to evaluate the histopathological and biochemical impact and effectiveness of two hemostatic agents, Ankaferd blood stopper (ABS) and Microporous Polysaccharide Hemospheres (MPH), on epidural fibrosis in an experimental rat laminectomy model. Material and methods: Twenty adult Wistar albino rats were divided into MPH-treated (n = 6), ABS-treated (n = 6) and control (n = 8) groups. Laminectomy of the lumbar spine was performed in all animals and treatment groups were exposed to MPH and ABS while closure was applied in control group as per usual. Epidural fibrosis was evaluated in all groups macroscopically, histopathologically, biochemically and with electron microscopy four weeks later. Results: Statistically, it was found that MPH-treated group had significantly less epidural fibrosis compared to ABS-treated and control groups. Conclusion: We compared two hemostatic agents for their propensity to cause adhesions in the present study. Our results show that MPH significantly reduces epidural scar formation and dural adhesion in a rat model of laminectomy while ABS increases postoperative fibrosis.
Journal of Neurosurgery: Spine, 2015
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 ...
A New Material for Prevention of Epidural Fibrosis After Laminectomy
Journal of Spinal Disorders & Techniques, 2006
Epidural fibrosis, which may cause persistent back and leg pain, may develop after laminectomy. Several materials have been used in attempts to minimize epidural fibrosis, with varying results. We evaluated the efficacy of an absorbable cellulose adhesion barrier in preventing epidural fibrosis. In 25 New Zealand white rabbits, laminectomies were performed at L3 and L5 vertebrae.
Objectives: Epidural fibrosis, which develops during the post-operative period in 6–20% of the patients who undergo lumbar spinal surgery, can cause persistent low-back pain and signs of root compression. Conservative treatment protocols or repeat operations performed for the symptoms of epidural fibrosis are long-term and costly treatments and impairs the patient's quality of life. In this experimental study, we applied methyl prednisolone acetate mixed with fibrin glue to the surgical field and examined the effects on epidural fibrosis in the surgical field by delaying the absorption of methyl prednisolone acetate. Methods: One hundred Sprague–Dawley rats were divided into five groups, and animals underwent total laminectomy of L4 and L5. We applied 0. 05 ml/kg fibrin glue, 0. 05 ml/kg methyl prednisolone acetate, 0. 05 ml/kg fibrin glue z methyl prednisolone acetate and 0. 10 ml/kg fibrin glue z methyl prednisolone acetate topically to the operative sites. Normal saline was applied in the control group. Following the surgery, animals were killed at weeks 1, 2, 4 and 6, and laminectomy sites were examined histopathologically for fibrosis, acute inflammation, necrosis and abscess formation. Results: None of the options had a statistically significant transcendence over others in terms of preventing epidural fibrosis. Conclusion: Many biological and non-biological materials have been tried in a quest to prevent epidural fibrosis. However, inducing least amount of injury to the anatomy of the tissues and a very good hemostasis seem to be the most effective methods in the prevention of epidural fibrosis.
Effectiveness of the Biophysical Barriers to the Peridural Fibrosis in Rat Laminectomy Model
Journal of Investigative Surgery, 2018
Purpose: Peridural fibrosis which could occur after the spinal surgery could adhere neural tissue closely and may cause to neural entrapment symptoms and require surgical reintervention. Aim of the study: Present study was designed to reduce occurrence of peridural fibrosis in rat laminectomy model by using biophysical barriers called hyaluronic acid (HAS) dural barrier, activated polyethylene glycol and polyethylene imine (PEG) dural barrier, and platelet-rich plasma (PRP). Materials and methods: In this study, 2 of 26 male Wistar albino rats (325-350 g body weight), which were not included into study groups were sacrificed by removing their total blood and their blood was used for preparation of PRP, and remaining rats were randomly delivered into four groups called SHAM, HAS, PEG, and PRP groups. Then L3-4-5 laminectomy was performed to all animals and experimental agents were administered to the selected groups mentioned above. Spinal colons of all animals were removed gross total after 6-week period and investigated histopathologically. Additionally, real-time-polymerase chain reaction was used to obtain collagen type I and type III, transforming growth factor-1β, and tumor necrosis factor-α gene expressions. Results: All results demonstrated that polyethylene glycol and polyethylene imine dural barrier and PRP could decrease peridural fibrosis formation efficiently in rat. Conclusion: Present study results suggested that to reduce or block formation of peridural fibrosis, either polyethylene glycol and polyethylene imine dural barrier or PRP could be used effectively in human subjects after they will be closely investigated in future studies.
TURKISH JOURNAL OF MEDICAL SCIENCES, 2021
Background/aim: To investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal) on epidural fibrosis (EF) following laminectomy in rats. Materials and methods: A total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF. Results: The results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3. Conclusion: Intraoperative Coseal, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.
European cells & materials, 2017
Post-operative epidural fibrosis is a biological response after laminectomy that may lead to clinical symptoms, such as radicular pain. An ideal material for prevention of epidural fibrosis should be able to inhibit fibroblast adhesions and reduce formation of scar tissue. An injectable hydrogel would be the material of choice for this purpose, since it could fill an irregular surgical defect completely, gelate in situ and be delivered in a minimally-invasive manner. The objective of this study was to evaluate, in vitro and in vivo, the cytocompatibility and anti-adhesive effect of an oxidised hyaluronic acid/adipic acid dihydrazide (oxi-HA/ADH) hydrogel. Different cell types present in the spine were used to test the cytocompatibility of the hydrogel. The hydrogel extraction medium had no deleterious effects on neural cells (PC-12), but reduced fibroblasts viability (NIH/3T3). Although the hydrogel did not change the release of lactate dehydrogenase from myoblasts (C2C12) and Schwa...