人工硬膜修补硬脊膜及预防椎管内粘连的实验观察

目的：观察人工硬膜（胶原海绵）敷贴修补硬脊膜破损的组织病理学反应和预防术后硬脊膜周围纤维化粘连的效果.方法：实验A,30只家兔随机分成3组,每组10只,造成硬脊膜纵形破损,随机分别应用人工硬膜、明胶海绵敷贴裂口处和旷置.术后8d和30d处死动物,行肉眼和组织学观察,同时进行缺损区瘢痕组织的成纤维细胞密度评级.实验B,12只家兔随机分成2组,每组6只,进行T10和T12椎板切除,使硬膜裸露,T10缺损旷置,作为空白对照,T12缺损用人工硬膜或明胶海绵进行覆盖,术后30d,处死动物取材.肉眼和组织学观察硬膜缺损处并按有关的组织学评级标准半定量分析.结果：实验A中人工硬膜在体内未引起不良反应.组织学观察发现植入物内有大量的成纤维细胞长入、毛细血管形成和胶原沉积,植入物有降解趋势.实验B中与空白对照组比较,人工硬膜组硬脊膜周围粘连较轻（P＜0.05）.结论：人工硬膜（胶原海绵）作为一种硬脊膜移植材料具有较好的组织相容性,有促进组织修复作用;早期能防止硬脊膜外瘢痕组织向椎管内侵入,起到空间屏障作用,在一定程度上减轻了纤维瘢痕组织侵入椎管所造成的硬脊膜周围纤维性粘连.     

同种异体骨板覆盖预防硬膜外瘢痕粘连的实验研究

目的 探讨经冻干辐照处理后的同种异体骨板预防椎板切除术后硬膜外瘢痕粘连的作用。方法 12只成年雄性绵羊,随机分成A、B两组,每组6只。两组均作L3,4和L4,5椎板切除,A组的L4,5和B组的L3,4椎板缺损用“H”形同种冻干辐照骨板覆盖,为实验节段;A组的L3,4和B组的L4,5不覆盖骨板作为对照节段。于术后4、8、12、16、20和24周取材,行大体、X线平片和组织切片观察;并对4、24周取材行CT扫描。结果 术后4周,实验节段可见同种骨板形态、位置保持完好,椎管内无狭窄,硬膜囊无压迫,镜下椎板咬除缘有多量新生骨小梁生成,周边有大量软骨细胞及其分泌黏多糖和坏死后所留下的空腔,骨板内侧有增生纤维组织及少量炎性细胞浸润;对照节段可见大范围致密的纤维组织夹杂变性坏死肌肉嵌入椎板缺损处,硬膜广泛粘连,硬膜囊受压。术后24周,实验节段椎管重建基本完成,覆盖骨板吸收完全,并与再生椎板融合,椎管形态完好,硬膜外未见瘢痕组织;对照节段椎板再生未完成,瘢痕组织自椎管外嵌入椎管内,压迫硬膜囊及脊髓,硬膜外间隙几乎消失。统计学分析表明手术后期（16～24周）,实验节段与对照节段相比硬膜粘连程度明显减轻,椎管矢状径均较对照节段大,硬膜囊形状保持良好,无明显压迫。结论 同种异体冻干辐照骨板在实验羊椎板切除后的硬膜外能有效减少瘢痕形成和粘连。     

聚乳酸凝胶预防硬膜外瘢痕粘连的实验研究

目的 探讨新型生物可吸收材料聚乳酸凝胶(polyactic acid glue，PLA-G)预防椎板切除术后硬膜外瘢痕粘连的作用。方法 切除24只成年日本大耳白兔的L2和L5椎板；在L5外露的硬膜及神经根表面喷涂液态PLA-G形成胶冻膜，为实验组；L2处只做椎板切除，为自身空白对照组。术后2、4、6、8、10及12周随机处死各4只兔，取标本行大体、组织学及超微结构的观察。结果 2周时实验组PLA-G未降解为机械屏障膜，硬膜与外侧瘢痕组织(scartissue，ST)间有明显间隙，光镜下显示间隙内无细胞；对照组为血肿覆盖较易分开，硬膜与ST间有血细胞团块，成纤维细胞(fibroblast，FB)增生活跃。4周时实验组PLA-G部分降解，机械屏障及间隙存在，光镜下ST中FB增多；对照组为较多质脆ST与硬膜广泛粘连，光镜下可见组织细胞浸润间隙，ST内FB明显多于实验组。6周时实验组PLA-G完全降解，少量ST与硬膜无粘连，光镜下FB已减少；对照组有大量质韧难以从硬膜分离的ST，FB继续增生活跃。8、10及12周时实验组ST与硬膜无粘连；对照组ST与硬膜粘连严重，光镜下见ST和硬膜粘连紧密伴毛细血管再造。超微结构观察：4周时实验组FB的粗面内质网较稀疏，分泌胶原纤维少；对照组FB的粗面内质网极丰富，胶原纤维多而成束。结论 PLA-G在实验兔腰椎板切除后的硬膜外能有效地减少瘢痕形成和粘连。     

三七凝胶预防椎板切除术后粘连的实验研究

目的:从大体、组织形态学观察分析三七凝胶预防椎板切除术后粘连的有效性和可行性。方法:84只Sprague-Daw ley大鼠(SD大鼠)按单纯随机方法分为4组:三七凝胶组(NG)、单纯三七组(N)、空白对照组(C)、纤维蛋白胶组(FG),每组21只。切除L1-L2右侧椎板,分别在硬膜囊周围涂抹三七凝胶、三七浓缩液、生理盐水、纤维蛋白胶。每组大鼠分别在术后2、4、8周处死。各组在每个时间段各处死7只,其中1个标本作大体观察瘢痕的量、范围、致密程度以及解剖过程中硬膜囊的完整性,其余6个标本作组织切片(HE染色)观察术后硬膜外瘢痕粘连的程度、计算椎管内粘连百分率。结果:术后各个时间段三七凝胶组椎管内预防粘连百分率明显优于单纯三七组、纤维蛋白胶组、空白组(P<0.05或P<0.01)。结论:三七凝胶可以作为一种良好的材料用于预防椎板切除术后硬膜外瘢痕粘连。     

自体真皮移植预防硬膜外纤维化及粘连的实验研究

目的 探讨自体真皮移植预防硬膜外纤维化及粘连的效果,为临床应用提供实验依据.方法 选取5头西藏小型猪,手术切除L2、L4全椎板造成缺损,去除硬膜后方硬膜外脂肪暴露硬脊膜,切取自体真皮移植于L2椎板缺损处覆盖硬脊膜(实验组),L4椎板缺损处硬脊膜外不用任何移植物覆盖(自身空白对照组).于术后2、4、6、8、10周全麻下股动脉放血法各处死1头动物,大体观察移植真皮存活情况及是否存在毛发生长、皮脂腺和汗腺分泌物.采用改良Robertson记分法评定硬膜外瘢痕量及粘连程度,SPSS 13.0统计学软件进行统计分析.组织学观察移植真皮内皮肤附属器变化情况.结果 移植真皮全部成活,与体表真皮比较明显增厚(P<0.05).实验组未见移植真皮毛发生长、皮脂腺囊肿和汗液囊肿形成;真皮与硬脊膜之间存在潜在的易分离平面,只有极少量瘢痕组织,粘连疏松,硬膜表面和移植真皮表皮面光滑.对照组大量的瘢痕形成,竖脊肌前方瘢痕组织严重且广泛长人硬膜外腔,与硬脊膜粘连紧密,硬脊膜从瘢痕组织上分离困难.改良Robertson记分法评分,实验组硬膜外瘢痕量及粘连程度明显低于对照组(P<0.05).组织学观察见毛囊萎缩、毛根坏死、皮脂腺及汗腺消失.结论 自体真皮是一种具有良好的抑制瘢痕形成和物理隔离屏障作用的生物材料.自体真皮移植能有效地预防硬膜外纤维化及粘连,具有临床应用价值.     

聚乙交酯膜预防椎管术后硬膜外瘢痕粘连的实验研究-大体组织学改变

目的观察聚乙交酯(PGA)膜对预防椎板切除术后硬膜周围粘连的作用.方法在新西兰兔L3、L5部位切除椎板1.0cm×0.5cm,一缺损处在硬膜外放置PGA膜,另一缺损部放置明胶海绵或空白对照,于术后3、6、9、12周作形态和组织学观察.结果大体形态观察PGA膜3周时开始降解,6周时分解成较大碎片,9周时吸收60%～80%,12周时仅残留部分小碎片,硬膜外无瘢痕粘连.明胶海绵和空白对照组瘢痕粘连发生率为88%和100%.组织学检查PGA膜组各时点均未见硬膜外纤维组织产生,硬膜与背侧组织无粘连,明胶海绵组(除3周外)和空白对照组均产生明显的粘连.结论PGA膜能有效防止椎管术后瘢痕粘连.     

应用人工硬脊膜预防瘢痕粘连早期临床观察

目的：介绍一种新的预防脊柱外科手术后瘢痕组织形成，硬膜粘连的一种方法，提高对椎板切除术后硬膜粘连的认识。方法：对17例腰椎间盘突出症椎板间开窗、间盘摘除的病人，术中应用美国戈尔公司生产的人造硬脊膜，术后3—6个月行核磁共振检查瘢痕组织的生成与硬膜粘连的情况。结果：17例应用人造硬脊膜的病人，3—6个月核磁共振示人造硬脊膜与脊髓之间无粘连，无瘢痕组织长入硬脊膜外空间，而同期手术的14例病人末应用此人工材料，其核磁共振影像均可见不同程度的瘢痕组织增生，脊髓与瘢痕组织粘连，神经根周围亦有瘢痕组织包裹、环绕。结论：人造硬脊膜有效降低了椎板切除术后瘢痕组织的产生程度，使病人减少了椎板切除术后瘢痕组织生成导致的疼痛，亦为二次手术创造了有利的条件。人造硬脊膜是一种比较理想的隔离物。     

活血止痛汤对硬膜外瘢痕组织中羟脯氨酸含量及其超微结构的影响

目的:评价活血止痛汤预防实验性椎板切除术后硬膜外瘢痕形成与粘连的疗效。方法:雄性SD大鼠90只随机分成空白对照组、透明质酸钠组、活血止痛汤组,每组30只。手术切除L4-L5腰椎椎板,造成0.25cm×1cm硬脊膜裸露区,透明质酸钠组于硬膜囊外均匀地涂抹一层透明质酸钠约0.3ml,其余2组以等量生理盐水处理。术后2周内活血止痛汤组予活血止痛汤2.5ml/kg灌胃;空白对照组和透明质酸钠组予等量生理盐水。术后第2、4、8周末处死动物,测定其硬膜外瘢痕组织中羟脯氨酸含量,按Rydell法评定粘连程度,透射电镜观察其超微结构。结果:第2周时,透明质酸钠组羟脯氨酸含量明显低于空白对照组(P<0.05),而活血止痛汤组虽然也较低,但差异无统计学意义(P>0.05);第4周时,与空白对照组相比,透明质酸钠组和活血止痛汤组羟脯氨酸含量均较低(P<0.05),但透明质酸钠组和活血止痛汤组的差异缺乏显著性。第8周时,活血止痛汤组羟脯氨酸含量不仅低于空白对照组(P<0.01),而且其与透明质酸钠组亦有显著性差异(P<0.05)。大体观察也发现透明质酸钠组和活血止痛汤组粘连程度明显降低(P<0.05)。各时相透明质酸钠组和活血止痛汤组瘢痕中成纤维细胞以及细胞内的细胞器数量均减少,胶原纤维的合成受到抑制。结论:活血止痛汤能降低硬膜外瘢痕中羟脯氨酸的含量,抑制瘢痕组织中成纤维细胞和胶原的代谢,减少硬膜外瘢痕的形成和粘连。     

黄芪预防术后硬膜外粘连的实验研究

目的：探讨黄芪预防术后硬膜外瘢痕粘连的效果。方法：22只新西兰兔行L2和L5节段2椎板切除术,切除部分黄韧带,暴露脂肪,去除硬膜外脂肪,分为两组：A组为黄芪组;B组为生理盐水组,分别在L2和L5椎板缺损区注入黄芪液和生理盐水,术后2、4、8周取材作光镜,透镜观察。结果：黄芪组炎性细胞渗出较少,成纤维细胞较少,胶原纤维形成较少,硬膜外瘢痕无粘连,脊髓和神经根未见变性和脱髓鞘,生理盐水组硬膜外明显。结论：黄芪无神经毒性作用,可作为作一种良好的材料用于预防术后硬膜外瘢痕粘连。     

钛合金微粒对硬膜外瘢痕粘连形成影响的实验研究

目的观察钛合金微粒对硬膜外瘢痕粘连的影响方法36只成年新西兰兔随机分为3组.切除L5椎板后造成10mm×5mm硬膜裸露区,A组植入钛合金微粒,B组植入不锈钢微粒,C组作为空白对照,术后4、8、12周分别进行肉眼和光镜观察,8周时进行硬膜外粘连等级评分和计算机图像分析.结果4周时3组均有大量瘢痕形成,瘢痕尚未成熟,其间可见纤维母细胞.8周时瘢痕成熟,肉眼及光镜硬膜外粘连等级评分,三组间无显著差异(P>0.05),计算机图像分析示A组、C组的粘连程度均轻于B组(P<0.01),而A组与C组无显著差异(P>0.05).12周时瘢痕组织转化为骨组织,硬膜外大量新生椎板形成,呈松质骨状.结论钛合金微粒对于硬脊膜及硬膜外组织具有良好的生物相容性,其对硬膜外瘢痕粘连的形成及发展无影响.     

Effect of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits

Objective: To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods: Twenty-four Japanese white rabbits underwent laminectomy (including the attached ligaments) at L2 and L5. After laminectomy at L5, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at L2, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intracellular structure of fibroblasts. Results: The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group, which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions: Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.     

Effect of polylactic acid glue in preventing epidural scar mdhesion after laminectomy in rabbits

Objective： To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods： Twenty-four Japanese white rabbits underwent laminectomy （including the attached ligaments） at Lz and Ls. After laminectomy at Ls, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at Lz, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intraceHular structure of fibroblasts. Results： The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group,which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions： Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.     

Mitomycin C-polyethylene glycol controlled-release film inhibits collagen secretion and induces apoptosis of fibroblasts in the early wound of a postlaminectomy rat model

Background contextRecovery from spine surgery is usually accompanied with the development of epidural scar adhesions from the abnormal proliferation of fibroblast and extracellular matrix–related metabolism. Polyethylene glycol (PEG) could alleviate the postsurgical adhesion formation with still leaving a gap between the sheet and the dura. However, PEG film could not function as a three-dimensional barrier to prevent adhesion completely. Mitomycin C (MMC) could also reduce the scar formation after surgery, but cytotoxicity and the administrative pathway prevent its application.PurposeOur purpose was to design and attest the role of new delivery system MMC-PEG controlled-release film in preventing the epidural scar adhesions after laminectomy in the rat model.Study design/settingA total laminectomy of L1 in the rat model was used to assess epidural fibrosis between and around the spinal nerves using a histochemistry assessment along with flow cytometry analysis.Patient sampleThe sample comprises 64 adult male Sprague-Dawley rats.Outcome measuresThe outcome measures are macroscopic evaluation, histological analysis, and flow cytometry analysis.MethodsLumbar laminectomies at L1 and L2 with a L1–L2 disc injury were performed on 64 adult male Sprague-Dawley rats. The rats were then randomized into four groups. In Group I, 25 mg PEG film was applied on the dura mater in the laminectomy area before the layers were sutured. In Group II, a cotton pad soaked with 0.05% MMC solution was kept on the laminectomy area for 5 minutes. In Group III, 25 mg PEG film containing 0.01% MMC was implanted on the laminectomy area. In Group IV, the laminectomy area was flushed with saline before wound closure. The rats were sacrificed 4 weeks after the operation. Macroscopic evaluation and histological analysis of epidural scar adhesion with the hematoxylin and eosin stain and Masson stain were used followed by the quantification of hydroxyproline (Hyp) and flow cytometry analysis of the apoptosis of fibroblasts in the scar tissues.ResultsThe recovery of all rats was uneventful after the operations. In the laminectomy sites of rats treated with MMC or MMC-PEG, the dura mater was clean without any evident adhesion or membrane. Collagen tissue hyperplasia significantly decreased in the MMC- or MMC-PEG–treated models. Accordingly, Hyp concentration was significantly reduced in these two groups compared with saline-control group. In addition, the apoptosis of fibroblasts, however, was significantly elevated in the MMC or MMC-PEG group compared with the saline-control group.ConclusionsThese results demonstrate that the treatment of postlaminectomy wounds with MMC-PEG film reduces the severity of adhesion by decreasing the concentration of Hyp and increasing the apoptosis of fibroblasts.     

几丁糖膜预防椎板切除术后硬膜周围粘连的实验研究

目的：观察几丁糖膜对预防椎板切除术后硬膜周围粘连的作用。方法：２４只成年新西兰白兔Ｌ３、Ｌ５水平切除椎板１０×０５ｃｍ,Ｌ３硬膜外放置几丁糖膜（Ａ点）,Ｌ５作为空白对照（Ｂ点）。分别于术后３周、６周、１２周进行大体形态、组织学观察。结果：Ａ点硬膜与瘢痕无明显粘连,硬膜外有空隙,未见明显异物、炎症反应;Ｂ点硬膜与瘢痕紧密粘连,瘢痕侵入椎管内,对硬膜有压迫。结论：几丁糖膜具有明显的预防硬膜周围粘连的作用。     

壳多糖膜预防椎板切除术后硬膜周围粘连的实验研究

目的　观察壳多糖膜预防椎板切除术后硬膜周围粘连的作用。方法　２４ 只成年新西兰白兔 Ｌ３ 、 Ｌ５ 水平切除椎板１ ．０ ｃｍ ×０ ．５ ｃｍ , Ｌ３ 硬膜外放置壳多糖膜（ Ａ 点） , Ｌ５ 作为空白对照（ Ｂ 点） 。分别于术后３ 、６ 、１２ 周进行大体形态、光镜观察。结果　 Ａ 点硬膜外粘连程度明显低于 Ｂ 点;光镜观察 Ａ 点粘连范围明显低于 Ｂ 点, Ａ 点硬膜外有空隙,未见明显异物、炎症反应, Ｂ 点硬膜外与瘢痕紧密粘连,瘢痕侵入椎管内,对硬膜有压迫。结论　壳多糖膜具有明显的预防硬膜周围粘连的作用。     

Epidural scar tissue formation after spinal surgery: an experimental study

Summary Extensive epidural scar formation is a wellknown complication after spine surgery. Fibrous adhesions around nerve roots are a major reason for recurrent neurological symptoms following lumbar discectomy. A large variety of materials, implanted onto the dura, have been used to prevent or reduce laminectomy membrane, with conflicting results. We therefore carried out an experimental study in dogs to compare those materials that seemed to be most suitable. In each of 30 adult beagles, three lumbar laminectomies were performed. Each level was covered with a different material — free autologous fat graft, cellulose mesh, Gelfoam or triamcinolone suspension. In a control group nothing was implanted. After 7 days or 1, 3 or 6 months the animals were killed. The lumbar vertebral columns were harvested and prepared for further histological examination. To compare the results, we designed a new classification scheme (scar index). The data were obtained without knowledge of implanted material or time since operation. We found that free autologous fat grafts are able to reduce epidural scar formation in a high proportion of cases, especially after 3 and 6 months; cellulose mesh showed the worst results. We conclude that free autologous fat grafts are superior to other materials because of simple operative handling, good compatibility and effective prevention of laminectomy membrane.     

Novel biodegradable lamina for lamina repair and reconstruction

Background contextPosterior laminectomy is an effective spinal surgical procedure. The adhesion of postoperative scar tissue to surgically exposed dura and, occasionally, to nerve roots can cause failed back surgery syndrome. The establishment of a barrier between scar tissue and dura that is made of hard material may prevent scar adhesions.PurposeTo evaluate the efficacy of a novel biodegradable multi-amino acid copolymer/nanohydroxyapatite composite artificial lamina.MethodsA cervical laminectomy animal model in goats was used, and the animals were randomly divided into three groups. In the test group, cervical 4 was removed by laminectomy and the artificial lamina was inserted (n=12). In the control group, the incision was closed directly without implantation (n=9). The goats in the normal group did not undergo any procedure or treatment. Copolymer efficiency was tested by using X-ray, computed tomography scanning, magnetic resonance imaging, scanning electronic microscope, and histologic and biomechanical measurements 4, 12, and 24 weeks postoperation.ResultsNo shifting of the artificial lamina or dural adhesion pressure was observed. New cervical natural bone formed in the defect and the bony spinal canal was rebuilt. In the control group, fibrous scar tissue filled the defect and exerted pressure on the dura. No paralysis was observed, and gait was normal in all test and control goats.ConclusionsArtificial lamina can prevent the epidural adhesions surrounding the defect and promote effectively bone tissue repair and new bone formation.     

The prevention of adhesions after laminectomy. Adverse results of Zenoderm implantations into laminectomy sites in rabbits

Zenoderm (Ethicon Ltd., Edinburgh, Scotland) is porcine skin dermis specially treated so as to be weakly antigenic when implanted. Its use as an extradural spinal and nerve root membrane to reduce postoperative adhesions after laminectomy was tested in 22 rabbits with laminectomy in the second and fourth lumbar vertebra. The sites were reviewed histologically two to 36 weeks after operation. Histologic sections showed that Zenoderm was initially surrounded by hematoma that organized into fibrous tissue and, later, bone. When Zenoderm was placed immediately adjacent to the dura, dense adhesions formed, which were slower to resolve than those in the control sites. The rate of Zenoderm resorption was variable. In general, Zenoderm did not excite excessive fibrous tissue formation and was slowly replaced by bone. Contrary to the experience of others, it was unusual to find adhesions between the laminectomy site, and the dura began disappearing after six to nine weeks. In rabbits, Zenoderm is unlikely to prevent adhesions forming after lumbar disc surgery. The resorption rate is variable, and laminectomy sites are unsuitable for the investigation of material for the prevention of spinal dural adhesions.     

纳米羟基磷灰石/聚酰胺复合人工椎板预防脊柱后路术后椎管内瘢痕粘连的实验研究

目的：探讨纳米羟基磷灰百／聚酰胺（nano-hydmxyapatite／polyamide-66，n-HA／PA66）复合人工椎板在防止脊柱后路术后椎管内瘢痕粘连，重建脊柱后部结构完整性的价值。方法：22只1岁龄雄性家犬行L5椎板切除，实验组13只行复合人丁椎板植入，另9只作空白对照。术后4、8、16、24周各时相点摄X线片，行组织学、扫描电镜观察；术后24周行MRI检查．结果：实验组术后16～24周复合人工椎板界面观察到软骨细胞及板层骨，硬膜粘连程度比对照组明瞳减轻（P〈0．01）。术后24周时MRi显示实验组椎管完整性恢复。结论：n-HA／PA66复合材料具有良好的生物相容性，能有效阻止硬膜外粘连。