| Objective: To study the preventive effect of S100 on epidural scar adhesion in animal model of laminectomy.Methods:Thirty-six adult New Zealand white rabbits(weight 2.4-3.1 kg)were randomly divided into two groups.Group 1 was the control group(only the Laminectomy was performed without other treatment)and group 2 was treated as experimental group(after Laminectomy,the S100 was used to cover the defect area).Each group had 18 experimental animals.The preparation of animal model: After the preoperative surgical preparation,anaesthesia,iodophor disinfection,spreading sterile towel,the middle incision was taken at the back.The incision was about 2-2.5 cm,and the spines and laminae of L6 were exposed,the area of bone defect was about 0.4 cm x1.1 cm,and the dural sac was exposed.The laminar defect area was treated as follows: In the first group the epidural was not covered any material.In the second group,S100 was trimmed to a suitable size of about 1.0 cm x 2.1 cm,and was directly covered the bone defect of the operative segment over the epidural sac.Items of observation: 1)to Observe the activity,feeding and wound healing of rabbits after operation.2)The rabbits were sacrificed at three time points(2nd,4th,8th week),and the specimens were made,the adhesion of the epidural scar tissue of rabbits was observed with the naked eye and was graded with Rydell score standard.3)Histological observation: At the three post-operative points(2nd,4th,8th week),the specimens were taken out,the slides were made,and the adhesion of the epidural scar tissue in the surgical area was observed under a microscope and graded with the Nuss-baum Standard Score.4)to count the number of fibroblasts in the tissue of epidural scar.Results: 1)visual observation: according to Rydell Score,Group 1and 2 were compared in 2,4 and 8 weeks respectively(p < 0.05).The three time points in Group 1 Rydell Scores were compared in the first group: Rydell Scores at 2nd week and 4th week,at 2nd week and 8th week were significant(p < 0.05),and at 4th week and 8th(p > 0.05),there was no significant difference between 2nd week and 4th week(p > 0.05),but the difference between at 2nd week and 8th week was statistically significant(p < 0.05).The difference between at 4th week and 8th week was not statistically significant(p > 0.05).2)Histological observation: According to the Nuss-baum Standard Score,the scores between the two groups at three time points were statistically significant(p < 0.05).Wihin group comparison at 4th week and 2nd,and at 4th week and 8th week in Group 1 was not significant(p > 0.05).Wether in Group 1 or Group 2,within-group comparison at three time points was not statistically significant(p > 0.05).3)The fibroblast count of the epidural scar tissue was statistically significant(p < 0.05)between Group 1 and Group 2(p < 0.05).In Group 1,there was no significant difference between at 2nd,4th and 8th weeks(p > 0.05).In Group 2,the fibroblast count at 2nd week and 4th weeks,4th and 8th weeks were not statistically significant(p > 0.05),but the comparison between at 2nd and 8th weeks was significant(p < 0.05).Conclusion: After Laminectomy,the hard ridge membrane can be easily attached to scar tissue.The S100 covered the epidural sac made by laminectomy and is dissolved into a gelatinous gel covering the rigid cristae membrane and surrounding tissues.When epidural hematoma occurs,TGF-beta,PDGF and fibroblast growth factor(FGF)can promote the proliferation and adhesion of fibroblasts,so S100 may inhibit the proliferation of fibroblasts to a certain extent by reducing the hematoma;on the other hand,S100 can cover the hard ridge membrane in the form of jelly-like Gel during tissue inflammation and granulomatous tissue formation.The formation of physical barrier partly blocks the contact of inflammatory factors and fibroblasts with the hard membrane and reduce the adhesion of scar. |
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