Reduction of epidural fibrosis and dural adhesions after lamina reconstruction by absorbable cement: an experimental study.

Abstract

Post-laminectomy epidural fibrosis complicates revision spine surgery and is implicated in cases of "failed back syndrome." Several materials have been used to minimize epidural fibrosis with varying results. The aim of this study was to examine the impact of reconstruction of laminectomy site with a type of absorbable cement (Jectos) to reduce epidural fibrosis. This investigation is an experimental controlled study, which is designed to evaluate the preventive effects of laminectomy site reconstruction in rat laminectomy model. Twenty wistar rats were included in this study and divided randomly to two equal groups, namely, subject and control. In both groups, laminectomy was performed in L2 and L4 levels. Control group received no additional treatment. In the subject group, L4 levels were reconstructed by Jectos and L2 levels were non-reconstructed as internal controls. Six months after surgery the rats were sacrificed and the dural adhesion and epidural fibrosis were evaluated macroscopically and microscopically. The study was financially supported by Brain and Spinal Cord Injuries Repair Center. None of the authors have any conflict of interest. Non-reconstructed levels in both groups showed dense epidural fibrosis with marked dural adherence. L4 reconstructed levels in subject group showed reduced epidural fibrosis macroscopically (p=.024) and microscopically (p=.041). No foreign body reaction or ossification occurred at reconstructed sites. In the present study, lamina reconstruction with absorbable cement was a safe method that significantly reduced post-laminectomy epidural fibrosis and dural adhesions in rat laminectomy model.