Abstract:

BACKGROUND: Peridural adhesion easily occurred after laminectomy. There is not an ideal drug or spacer to prevent adhesion.
OBJECTIVE: To study the effectiveness of combination of auto-genous fat particle and urokinase on prevention of peridural adhesion.
METHODS: Totally 64 adult New Zealand rabbits were randomly divided into the model, urokinase, autogenous fat particle and autogenous fat particle + urokinase groups, with 16 animals in each group. Laminectomy was performed on the 5th lumbar segment and the duramater (12 mm × 5 mm) was exposed. The exposed duramater was covered with saline, urokinase (25 U/kg), autogenous fat particle or the combination of autogenous fat particle and urokinase (25 U/kg) in the model, urokinase, autogenous fat particle and autogenous fat particle + urokinase groups, respectively. The specimens were observed grossly and histologically at 2 and 4 weeks postoperatively. The computed imaging analysis on the area of peridural scar tissue was also performed at 6 weeks postoperatively.
RESULTS AND CONCLUSION: Severe peridural adhesion was formed in the model group, slight adhesion formed in the urokinase and autogenous fat particle groups, but no obvious adhesion formed in the autogenous fat particle + urokinase group. The number of fibroblasts was dramatically lower in the urokinase, autogenous fat particle and autogenous fat particle + urokinase groups than those in the model group (P < 0.05), especially lowest in the autogenous fat particle + urokinase group (P < 0.05). Compared with the model group, the area of peridural scar tissues were significant lower in the urokinase, autogenous fat particle and autogenous fat particle + urokinase groups (P < 0.05), lowest in the autogenous fat particle + urokinase group. The autogenous fat particle combined with the urokinase has the best preventive effect on the peridural adhesion after laminectomy.