Prevension Epispinal Scar Tissue Adhesion By The Use Of Fascia Thoracolumbalis Following Releasing The Tethered Cord In Tethered Cord Syndrome: An Experimental Study In Rabbits

Objective: The term tethered cord syndrome has been used to describe a constellation of symptoms and findings that are though to be caused by traction on the end of the spinal cord. This tension or tration by the adhension of the dura mater or spinal canal restricts the spinal cord's regular retraction to the head side. The symptomatology includes dysfunction limited to the lumbosacral cord, a high incidence of incontinence, or motor and sensory dysfunction. Early operation is benefical to partly function' s recovery and to prevent more lesion to nerve.In the TCS of the children patients, the reason usually is caused by spina bifida and myelomeningocele, especially with intradural lipoma. In this kind of symptom, the dura mater is often partly defective. Postoperatively,the restorative course is fibrous tissue hyperplasia and scar formation. The scar tissue adheses the exposed spinal cord. The syndrome is recurrent.Until now, how to prevent the syndrome's recurrenting of this kind of syndrome. It is a difficult clinical problem eagerly needing to solve early. My experiment is to study the effect of fascia thoracolumbalis in the prevension of epispinal fibrous scar formation following releasing the tethered cord in tethered cord syndrome with the defect of the dura.Methods:Laminectomies were performed at the last 3 lumbar vertebrane in 72 adult rabbits as models. They are allocated randomly into three groups.Group A: adult rabbits' duras were cut and sutured,they are served as the postoperative models with the complete dura.Group B: adult rabbits' duras were get rid of and fascia thoracolumbalis' laevigate side was put on the surface of the spine. Group C: adult rabbits' duras were get rid of, and left empty. The formation of fibrosis and the adhesion of the spine were evalued at 4,8,12weeks after operation.Methods of observationincludedgross anatomical evaluation,fibroblasts counting,computer-assistedimageanalysisandclass ification.Results :Scar formed in group C at the fourth week, reached a peak at the eighth week and began to soften and shruk at the twelfth week. In methods of observation included gross anatomical evaluation, histological evaluation,computer-assisted image analysis, fibroblasts counting , Group A and Group B have the similar results(P >0.05), Group B and Group C had a significant efficacy in the prevesion of scar formation, Group B much less than Group C(P <0.01)Conclusion:In the kind of the tethered cordsyndrome with the defect of dura mater postoperatively, scar tissue adheses the spinal cord and cause recurrenting. Putting fascia thoracolumbalis' laevigate side on the surface of the spine is suitable and blocompatible and efficient. It also serves as a barrier to prevent the migration of hematoma and inflammatory cells and fibrablasts and to prevent spine adhesion and to reduce the invension of the scar tissue in the spinal canal.Postgratude Xing Tao (Pediatric Surgery) Directed by Yang Chuanmin...