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Prevention of anterior scar formation following discectomy with a MediShield adhesion barrier: randomized
Hasan Kamil Sucu1, Ismail Ertan Sevin, Turkan Rezanko
1Atatürk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey. hsucu@yahoo.com
Aim:
To investigate whether carboxymethylcellulose/polyethylene oxide (CMC/PEO) gel has a protective effect against epidural scar formation anterior to the dura following discectomy.
Material And Methods:
A barrier gel comprised of CMC and PEO (MediShield) was studied as a material to reduce anterior epidural scar formation in a rabbit laminotomy and discectomy model. After laminotomy and disc puncture, the surgical side was either treated with MediShield or used as a surgical control, as determined by random allocation. Two months after surgery, the animals were euthanized, and their lumbar spines were removed in an en bloc excision for pathological evaluation. Scar formation was evaluated as present or absent.
Results:
The MediShield group contained 12 rabbits, and the control group contained 7 rabbits. Epidural fibrosis was observed in two out of twelve specimens (17%) in the MediShield group and in three of seven (43%) cases in the control group (P=0.305, Fisher's Exact Test).
Conclusion:
Though it was not statistically significant, we observed a difference between the MediShield and control group that favored the MediShield group. The application of the CMC/PEO gel might protect against epidural fibrosis after lumbar discectomy, but its efficacy needs to be investigated in larger experimental trials.
