Prevention From Peridural Adhesion After Laminectomy By Combined Application Of Fat Particle And Urokinase

Objective:To study the efectiveness of various materials including autogenous fat particle, urokinase and the combination of autogenous fat particle and urokinase on prevention of peridural adhesion.Methods:Laminectomy was performed on the 5th lumbar segment in 56 rabbits, which were equally divided into 4 groups. The duramater(12 mm×5 mm)was exposed. The exposed duramater was covered with saline in Group A(control); the exposed dura mater was covered with urokinase (25u/kg)in Group B; the exposed dura mater was covered with autogenous fat particle in Group C; the exposed dura mater was covered with the combination of autogenous fat particle and urokinase(25u/kg) in Group D. The specimens were observed grossly and histologically at 2,4 weeks postoperatively,and the number of fibroblasts were determined. The computed imaging analysis on the area of peridural scar tissue was also performed at 6 weeks postoperativel.Results:①The gross anatomical evaluation:Severe peridural adhesion was formed in Group A, less adhesion formed in Groups B and C, but no obvious adhesion formed in Group D;②the number of fibroblasts:the number of fibroblasts were 43.2±2.5,40.2±2.7,20.3±1.5 in Groups B,Cand D respectivel,which were significantly lower than those in Groups A(61.9±4.3, P< 0.05);③the area of peridural scar tissue:the area of peridural scar tissue was 4.24±0.26mm2,3.22±0.22mm2 in Groups C and D respectivel, which were significantly lower than those in Groups A and B (6.32±0.33 mm2,6.18±0.29 mm2, P< 0. 05).Conclusion:The autogenous fat particle combined with the urokinase has the best preventive effect on the peridural adhesion after laminectomy.