Options for preventing postlaminectomy adhesion: a comparative study in rabbit model.
OBJECTIVE: To compare the various methods for prevention of peridural adhesion. METHODS: Laminectomy was performed in lumbar 1, 3 and 5 segments in 30 adult rabbits that were divided into 5 groups. A 10 mmx5 mm dura was exposed, and then covered with autogenou purifieds pearl fat (APPF) mixed with basic fibroblast growth factor (bFGF) in Group A, with APPF treated with insulin in Group B, with APPF in Group C, with 2% sodium hyaluronate (SHA) in Group D, and uncovered in Group E. The slide sections for histological study were observed at 2, 4, 6, 8 and 12 weeks postoperatively. The specimens were observed with a computed imaging analysis system at 4 and 8 weeks postoperatively. RESULTS: Severe peridural adhesions were formed in Groups B, C, D and E after laminectomy. But no adhesion was formed in the Group A at all time points. bFGF could stimulate pearl fat revascularization, increase the number of newly formed vessels and contribute to the survival of pearl fat. However, insulin had no certain effect in preventing degradation and deterioration of pearl fat. SHA had some effect in prevention of peridural adhesions only in the early stage, which was weakened with the lapse of time. CONCLUSIONS: APPF implantation mixed with bFGF provides a potential new approach to improving fat survival and preventing peridural adhesion postlaminectomy.