干扰素/聚乳酸-羟基乙酸共聚物及壳聚糖/聚乳酸-羟基乙酸共聚物复合膜防止椎板切除后的硬膜外瘢痕粘连

摘要 背景：应用硬膜外阻隔材料是预防椎板切除后硬膜外瘢痕粘连的一种方法,而制备既有机械阻隔能力,又有抑制成纤维细胞的能力的复合膜是其中一个重要的研究方向。 目的：制备壳聚糖/聚乳酸-羟基乙酸共聚物[poly(lactic-co-glycolic acid), PLGA]与干扰素/PLGA复合膜,观察其防止兔椎板切除后硬膜外瘢痕粘连的作用。 方法：大耳白兔120只行L2椎板切除,随机分为6组：对照组硬膜外不放任何物质;自体游离脂肪移植组取皮下脂肪贴于硬膜表面;透明质酸钠组将透明质酸钠1 mL 滴于硬膜外;PLGA膜组、壳聚糖/PLGA及干扰素/PLGA复合膜组,分别将各种膜修剪成合适大小植于硬膜外。术后2,4,6,8 周处死动物,观察L2术区的瘢痕形成及与硬膜粘连的情况并评分。术后4周,透射电镜下观察成纤维细胞的超微结构。 结果与结论：随着时间的延长,对照组形成较广泛的瘢痕。游离脂肪组和PLGA膜组的瘢痕量少于对照组。透明质酸组早期瘢痕形成量明显少于自体游离脂肪组和PLGA膜组,后期无显著性差异,但优于对照组。壳聚糖/PLGA膜组与干扰素/PLGA膜组硬膜外瘢痕的形成量最少,与硬膜无或轻微粘连,其作用明显优于其他各组,但两种复合膜组间差异不明显。术后4周,对照组、游离脂肪组和PLGA膜组的成纤维细胞的状态和功能明显好于壳聚糖/PLGA膜组与干扰素/ PLGA膜组。壳聚糖/PLGA复合膜与干扰素/ PLGA复合膜是预防椎板切除后硬膜外瘢痕粘连的有效材料。 关键词：聚乳酸-羟基乙酸共聚物;干扰素;壳聚糖;硬膜外瘢痕;椎板切除 doi:10.3969/j.issn.1673-8225.2010.47.043     

自体脂肪颗粒与尿激酶联合应用预防硬膜外粘连*

背景：椎板切除后,易发生硬膜外粘连。术后在硬膜外单独应用1种药品或隔离物,效果不甚理想。 目的：观察自体脂肪颗粒与尿激酶联合应用预防椎板切除后硬膜外粘连的效果。 方法：64只成年新西兰兔随机分为模型组、尿激酶组、自体脂肪颗粒组、尿激酶+自体脂肪颗粒组,各16只。手术切除L5椎板造成12 mm×5 mm 硬脊膜裸露区,探查神经根。模型组注入生理盐水,尿激酶组注入尿激酶(25 U/kg), 自体脂肪颗粒组用自体游离脂肪颗粒覆盖,尿激酶+自体脂肪颗粒组用尿激酶(25 U/kg)注入后再用自体游离脂肪颗粒覆盖。术后2,4周行大体观察及组织学观察,6 周时行硬膜外瘢痕面积定量分析。 结果与结论：模型组椎板切除部位明显粘连,尿激酶组、自体脂肪颗粒组轻度粘连,尿激酶+自体脂肪颗粒组无明显粘连。尿激酶组、自体脂肪颗粒组、尿激酶+自体脂肪颗粒组成纤维细胞数显著低于模型组(P < 0. 05),尿激酶+自体脂肪颗粒组成纤维细胞数低于尿激酶组、自体脂肪颗粒组(P < 0.05)。自体脂肪颗粒组、尿激酶+自体脂肪颗粒组瘢痕面积显著低于模型组、尿激酶组(P < 0.05),尿激酶+自体脂肪颗粒组瘢痕面积低于自体脂肪颗粒组。提示脂肪颗粒及尿激酶联合应用对预防椎板切除后硬膜外粘连具有协同作用,效果显著。     

干扰素/聚乳酸-羟基乙酸共聚物及壳聚糖/聚乳酸-羟基乙酸共聚物复合膜对椎板切除后脊髓c-fos表达的影响☆

背景：应用硬膜外阻隔材料是预防椎板切除术后硬膜外瘢痕粘连的一种方法，而制备既有机械阻隔能力，又有抑制成纤维细胞能力的复合膜是其研究方向。 目的：制备壳聚糖/聚乳酸-羟基乙酸共聚物(poly(lactic-co-glycolic acid), PLGA)与干扰素/PLGA复合膜，观察其减少脊髓伤害性刺激因子c-fos表达的作用。 设计、时间及地点：2005-05/2007-04在中科院长春应用化学研究所完成材料制备，随机对照动物实验在解放军第二○八医院实验动物室完成。 材料：PLGA膜、壳聚糖/PLGA及干扰素/PLGA复合膜由中科院长春应用化学研究所制备。 方法：大耳白兔120只行L2及L4椎板切除，然后随机分为6组，每组20只，于椎板缺损区处理如下：①空白对照组：硬膜外不放任何物质。②自体游离脂肪组：取皮下脂肪贴于硬膜表面。③透明质酸钠组：透明质酸钠1 mL涂于硬膜外。④PLGA膜组、壳聚糖/PLGA及干扰素/PLGA复合膜组：分别将各种膜修剪成合适大小植于硬膜外。 主要观察指标：术后2，4，6，8周处死动物，取L1~2节段脊髓，对L2脊髓横切片并行免疫组化染色，显微镜下观察并计数Fos样免疫反应阳性细胞。 结果：脊髓内有c-fos的表达，随时间的增长，其表达量逐渐增多，主要在脊髓背角浅层；实验各组Fos样免疫反应阳性细胞计数均低于空白对照组（P < 0.01），晚期以壳聚糖/PLGA复合膜及IFN /PLGA复合膜组的表达量少，与其他组比较差异有显著性意义（P < 0.01）。 结论：壳聚糖/PLGA与干扰素/PLGA复合膜可减少椎板切除术后脊髓c-fos的表达。     

腰椎术后14例脑脊液漏的护理体会

脑脊液漏是腰椎手术常见的并发症之一,硬脊膜撕裂的病例多为腰椎再次手术、峡部裂导致的腰椎滑脱、腰椎骨折、硬膜外注射药物。硬脊膜与椎板、黄韧带、后纵韧带粘连紧密,分离困难,术中减压和间盘切除时撕裂硬脊膜;少数患者是由于术中操作不当引起。较大的硬脊膜撕裂,术中可以及     

钙通道阻滞剂对体外培养神经瘢痕成纤维细胞增殖及胶原分泌的影响☆

目的：钙通道阻滞剂可抑制瘢痕成纤维细胞的增殖及胶原蛋白的分泌，减少瘢痕的增生。实验拟进一步观察钙通道阻滞剂对体外培养神经瘢痕成纤维细胞增殖及胶原分泌的影响。 方法：实验于2006-03/06在吉林大学中日联谊医院中心实验室完成。①实验材料：Wistar大鼠10只；盐酸维拉帕米注射液为上海禾丰制药有限公司产品。②实验过程及分组：制作大鼠双侧坐骨神经损伤模型，术后2周取损伤处神经瘢痕，按组织块法培养神经瘢痕成纤维细胞，实验所用细胞为4~8代，分4组，其中3组培养基中维拉帕米药物浓度分别为10，50及100 μmol/L，1组为空白对照组。③实验评估：分别用四甲基偶氮唑盐法观察细胞增殖能力、羟脯氨酸比色法测定细胞上清液中的胶原含量和胞浆中的胶原含量。 结果：①四甲基偶氮唑盐法观察细胞增殖结果：钙通道阻滞剂对神经瘢痕成纤维细胞的生长增殖具有明显抑制作用，且呈现剂量依赖性(P < 0.05)。②羟脯氨酸比色法测定胶原含量：钙通道阻滞剂可使分泌到细胞培养上清中的胶原含量明显减少，以100 μmol/L浓度组作用最为显著(P < 0.05);胞浆中的胶原含量增加，具有明显剂量依赖性，以100μmol/L浓度组作用最为显著（P < 0.05）。 结论：钙通道阻滞剂可以抑制神经瘢痕成纤维细胞的增殖及胶原分泌。     

去炎松-A固体脂质纳米颗粒透皮吸收在瘢痕治疗中的效应

目的：为克服目前瘢痕非手术治疗中糖皮质激素治疗的副作用，尝试应用去炎松-A固体脂质纳米颗粒经透皮吸收技术治疗瘢痕，观察其效果。 方法: 实验于2007-04/08在解放军兰州军区总医院动物实验中心实验室进行。①造模：选用新西兰白兔16只，每个兔耳上将全层皮肤切除，形成1 cm×1 cm上、下两个创面，术后30 d上皮化生逐渐形成病理性瘢痕。②分组干预：造模成功后随机分为对照组和实验组，每组8只。对照组不干预，实验组于术后30 d起应用含有去炎松-A 1 mg/cm2 的固体脂质纳米颗粒卡波姆凝胶覆于已形成的瘢痕上透皮吸收。③观察指标：分别于模型形成后第30，60，90和120天时依次取每只大白兔左耳上、下，右耳上、下的病理性瘢痕作为标本来源进行组织病理学观察，同时采用免疫组化检测组织中的ki-67表达和羟脯氨酸含量，并抽静脉血测血中皮质醇浓度。 结果：16只白兔均进入结果分析。①实验组做模型后第30天时ki-67表达及羟脯氨酸含量与对照组比较无明显差异（P > 0.05），但第60，90和120天实验组瘢痕组织中表达及羟脯氨酸含量较对照组明显减少（P < 0.01）。②实验组及对照组各时段血中的皮质醇浓度比较无明显差异（P > 0.05）。③实验组造模后120 d病理性瘢痕中成纤维细胞的数量少于对照组。 结论：含有去炎松-A 1 mg/cm2 的固体脂质纳米颗粒卡波姆凝胶透皮吸收对瘢痕有治疗作用，且长期应用血液中的皮质醇浓度不升高，能预防糖皮质激素治疗瘢痕的副作用。     

脊髓防粘连膜的生物相容性与可降解性

摘要 目的：评价组织工程材料脊髓防粘连膜的生物相容性及可降解性。 方法：第一作者应用计算机检索PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)及CNKI数据库(www.cnki.net/index.htm),以“生物相容性;壳聚糖;脊髓;生物材料”或“Biocompatibility; chitosan; spinal cord; biological materials”为检索词进行检索。选择文章与检索关键词材料学特点、生物相容性及其应用效果相关,同一领域文献则选择近期发表或发表在权威杂志文章。共纳入42篇文献。 结果：预防和减少经椎管内脊柱手术术后硬膜外瘢痕粘连一直是脊柱外科的研究热点。植入防粘连材料是预防和减少硬膜外瘢痕粘连的主要方法。理想的防粘连材料应该具有良好的生物相容性,无炎症反应,不产生排斥;能有效地覆盖手术部位,防止纤维组织长入,降解时间适当,无毒副作用等。壳聚糖是一类极具发展潜力的天然生物材料,其在生物医药材料中的研究以及应用越来越受到重视。 结论：壳聚糖是一类具有良好生物相容性的材料,可以发挥预防椎板切除术后硬膜外粘连的优势,同时可明显抑制椎板切除术后硬膜外胶原组织的增生及代谢,从而减少瘢痕组织的形成,在组织工程研究中有广阔的应用前景。 关键词：壳聚糖;生物相容性;脊髓;生物材料;防粘连膜 doi:10.3969/j.issn.1673-8225.2010.42.031     

红花对兔耳增生性瘢痕成纤维细胞及Ⅰ、Ⅲ型胶原的影响

背景：研究发现红花对体外培养的人增生性瘢痕成纤维细胞的增殖和胶原合成有抑制作用,但其具体作用机制与活体研究尚未进一步展开。 目的：观察红花对兔耳增生性瘢痕成纤维细胞及Ⅰ、Ⅲ型胶原表达的影响。 设计、时间、地点：随机对照动物实验,于2006-11/2008-03在重庆医科大学附属儿童医院动物实验中心及研究所完成。 材料：新西兰大白兔27只,雌雄不限;50%红花注射液由山西太原华卫药业有限公司产品,批准文号：国药准字Z14020008。 方法：兔耳腹侧建立增生性瘢痕模型,每耳2块。分为5组。术后第45天开始对增生性瘢痕行注射治疗。①正常皮肤组：为自身兔耳腹侧皮肤。②阳性对照组：右耳外侧增生性瘢痕,不予以任何处理。③生理盐水组右耳内侧增生性瘢痕,注射生理盐水。④低浓度红花组：左耳内侧增生性瘢痕,注射125 g/L红花液。⑤高浓度红花组：左耳外侧增生性瘢痕,注射500 g/L红花液。1次/周,连续注射4次。注射后第2,4,6周分别切取8只兔耳增生性瘢痕及皮肤待查。 主要观察指标：瘢痕厚度,硬度;Mallory染色检测成纤维细胞密度胶原纤维排列及致密度。免疫组织化学方法检测每块组织Ⅰ、Ⅲ型胶原面密度,计算Ⅰ/Ⅲ型胶原比值。 结果：注射后第4,6周,各组增生性瘢痕色泽均逐渐变浅,厚度及硬度均逐渐变小,尤以高浓度组明显,差异与其他增生性瘢痕组比较存在显著性意义(P < 0.05)。注射后第4,6周,高浓度红花组成纤维细胞密度较其他增生性瘢痕组低(P < 0.05)。注射后第4,6周,高、低浓度红花组I型胶原面密度值较阳性对照及生理盐水组低(P < 0.05),且高浓度红花组低于低浓度红花组(P < 0.05);各增生性瘢痕组Ⅰ/Ⅲ型胶原比值在注射后第2,4,6周均逐渐增高;同一时间段,高浓度红花组Ⅰ/Ⅲ型胶原比值为所有增生性瘢痕组中最低(P < 0.05),低浓度红花组Ⅰ/Ⅲ型胶原比值与阳性对照及生理盐水组比较,差异有显著性意义。 结论：高浓度红花液能促进兔耳增生性瘢痕的软化,组织顺应性增加。     

碱性成纤维细胞生长因子与瘢痕成纤维细胞Ⅰ、Ⅲ型胶原蛋白的代谢☆

背景：研究证实碱性成纤维细胞生长因子有促进创面愈合的作用,然而其在促进创面愈合的同时是否会引起成纤维细胞的增殖而导致瘢痕增生已受到学者的广泛关注。 目的：探讨碱性成纤维细胞生长因子对瘢痕成纤维细胞Ⅰ、Ⅲ型胶原蛋白合成和降解的调控作用。 方法：增生性瘢痕组织取自中山大学附属第一医院烧伤科行瘢痕整复术的患者,组织块法培养瘢痕成纤维细胞。取第2代细胞,采用氯胺T法、RT-PCR和Western blot法检测不同浓度(0~500 µg/L)碱性成纤维细胞生长因子对瘢痕来源的成纤维细胞Ⅰ、Ⅲ型胶原蛋白及细胞基质金属蛋白酶1合成和分泌的影响。 结果与结论：碱性成纤维细胞生长因子对瘢痕成纤维细胞羟脯氨酸及Ⅰ、Ⅲ型胶原蛋白mRNA的表达均无促进作用。低质量浓度碱性成纤维细胞生长因子对细胞基质金属蛋白酶1的表达无明显影响,但随着质量浓度的升高表现为增高趋势,以50,100,500 µg/L组增高最显著(P < 0.05或P < 0.01)。同时,细胞基质金属蛋白酶1的表达在细胞与上清中变化一致。说明高质量浓度碱性成纤维细胞生长因子可以通过增加细胞基质金属蛋白酶1的合成来促进胶原蛋白降解,从而避免细胞外基质的过度沉积。 关键词：碱性成纤维细胞生长因子;成纤维细胞;细胞基质金属蛋白酶1;瘢痕;胶原蛋白     

姜黄素对瘢痕疙瘩成纤维细胞胶原合成的影响

背景：近期研究提示姜黄素可能是一种抗纤维化制剂。 目的：以瘢痕疙瘩成纤维细胞为靶细胞，观察不同浓度姜黄素对瘢痕疙瘩成纤维细胞合成胶原的影响。 设计、时间及地点：随机对照实验，于2006-10/2007-11在解放军第四军医大学西京医院烧伤与皮肤外科完成。 材料：瘢痕疙瘩患者的手术标本5份，患者均知情同意。治疗方案经医院医学伦理委员会批准。姜黄素为美国Sigma公司产品。 方法：瘢痕疙瘩成纤维细胞体外原代培养，待细胞融合后传代，取第3~6代对数生长期的成纤维细胞用于实验。将不同浓度姜黄素(5，10，20 μmol/L)分别对瘢痕疙瘩成纤维细胞干预24~48 h，以空白组做对照。 主要观察指标：蛋白免疫印迹检测姜黄素作用瘢痕疙瘩成纤维细胞后结缔组织生长因子的表达。荧光定量聚合酶链反应检测姜黄素作用瘢痕疙瘩成纤维细胞后Ⅰ、Ⅲ型前胶原及结缔组织生长因子基因的表达。 结果：①姜黄素作用瘢痕疙瘩成纤维细胞 48 h后，结缔组织生长因子蛋白的表达减少，均低于对照组（P < 0.01）。②与对照组相比，不同浓度姜黄素干预组Ⅰ、Ⅲ型前胶原及结缔组织生长因子表达均降低（P < 0.01），并且Ⅰ型前胶原表达随着药物浓度的增加，有逐渐降低的趋势，成明显的量效关系。姜黄素20 μmol/L组Ⅲ型前胶原表达低于姜黄素10 μmol/L组，但差异无显著性意义（P > 0.05），姜黄素10 μmol/L组结缔组织生长因子表达低于姜黄素5 μmol/L组，但差异无显著性意义（P > 0.05）。 结论：姜黄素对体外培养的瘢痕疙瘩成纤维细胞胶原合成有明显抑制作用，其作用机制可能与姜黄素抑制结缔组织生长因子在瘢痕疙瘩成纤维细胞的表达有关。     

自制生物型人工硬脑膜与美国进口同类产品的比较

目的通过对临床病人及犬的开颅手术,观察应用自主创新人工硬脑膜的预后,并与应用美国进口同类产品(脑膜卫士)比较。方法选择临床手术病人39例,24例应用自创材料,15例应用脑膜卫士修补硬脑膜;选择犬10只,分为5组,分别为1、6、12、24个月及更长时间,每组犬各2只,每只犬于左右头顶分别应用自创材料与脑膜卫士修补硬脑膜。手术后对比观察不同修补材料的效果。结果犬解剖显示,应用自创材料的外表面与颅骨膜有少许丝状粘连、易分离,与周边缝合的硬脑膜已完全愈合,不可分辨,不能分离。从自创材料及脑膜卫士两种修补材料内表面来看,前者生长更接近硬脑膜,与脑表面无粘连或偶有丝状粘连。组织学镜下显示,两种修补材料与硬脑膜之间无嗜中性粒细胞、淋巴细胞等炎症细胞反应,无囊壁形成。自创材料内表面可见上皮细胞覆盖,上皮下可见纤维组织增生,纤维母细胞增生,该材料被降解,总量明显减少,内部可见毛细血管。结论用自创材料做硬脑膜修补手术后,该型材料的特性使其能产生上皮,不形成与脑组织的粘连,并逐渐被自体组织替代,达到具有实际意义的硬脑膜重建。     

Evaluation of epidural scar formation in lumbar spine after TachoComb application - an experimental study

BACKGROUND AND PURPOSE: Scar formation after spine surgery in the lumbosacral region may be the cause of failed back surgery syndrome. Therefore efforts are made to find materials preventing excessive scar formation at the site of surgery. The aim of the study was to evaluate the usefulness of TachoComb application in prevention of epidural scar formation in a rat experimental model. This paper additionally presents a review of literature concerning other methods of local suppression of scar formation after posterior approaches to the lumbar spine. MATERIAL AND METHODS: The experimental study was carried out on 14 male Wistar rats. Rats were divided into 2 groups. Laminectomy was performed in the first group (control group: n=5). In the second group of animals (n=9) laminectomy was followed by TachoComb application on the exposed dura. Neurological condition of the studied animals was evaluated based on clinical observation, neurological tests and recording of somatosensory evoked potentials. Post mortem histological examination was the main method of assessment of the experimental material. RESULTS: Presence of scar in the vertebral canal, its extent and severity differed between experimental groups. Electrophysiological results were also different between studied groups. CONCLUSIONS: TachoComb prevents epidural scar formation after lumbar spine surgery. Its positive effect concerning neural transmission at the level of the medulla was proven by electrophysiological tests in which the amplitude of components I and II of SSEP in the TachoComb group were significantly higher than in the control group.     

A carbohydrate polymer that effectively prevents epidural fibrosis at laminectomy sites in the rat.

We demonstrate that a carbohydrate polymer, designated GL402, effectively inhibits epidural fibrosis in a rat laminectomy model. A total laminectomy in Lewis rats was performed at lumbar vertebrae 3 and 5. GL402 or phosphate buffer solutions in gelatin sponges were applied to the laminectomy sites. Epidural fibrosis was measured, using a double-blind protocol, 2 weeks postoperatively either by gross anatomical evaluation (blunt dissection) or by histological evaluation. Local application of GL402 produced nearly complete inhibition of epidural fibrosis, whereas extensive scar formation and bone growth occurred after local application of buffer or other purported anti-fibrotics. In laminectomy sites treated with GL402 the dura mater was essentially free of adhering fibrosis and bone growth was dramatically decreased. With reduction of postlaminectomy fibrosis, the spinal nerve roots are more mobile and therefore may be less prone to recurrent nerve root compression. The dramatic reduction of epidural fibrosis by GL402 will make reoperative disc surgery safer due to greater accessibility of the laminectomy site. This compound may be useful in preventing surgical adhesions in other sites as well.     

Immunomodulatory effectiveness of azithromycin in prevention of postlaminectomy epidural fibrosis

Abstract

Objective: One of the important causes of failed back surgery is the extensive peridural fibrosis collecting in the surgical field after spinal surgeries. Today we know that inflammatory mechanisms mediated by the immune system of the body plays an important role in generation of fibrosis. Azithromycin, a macrolide antibiotic, has proven immunomodulatory effects in various diseases. This study aims to investigate the effects of azithromycin on peridural fibrosis

Methods: Twenty-four Wistar rats received laminectomies before dividing them into three groups randomly. Animals of the control group received normal saline intraperitoneally while animals in the treatment groups received low (20 mg/kg) and high (80 mg/kg) doses of azithromycin intraperitoneally after surgical interventions. The amount of fibrosis, fibroblast density and inflammatory cell density were analyzed histologically.

Results: Analysis demonstrated significantly reduced fibrosis, fibroblast density and inflammatory cell density in treatment groups compared to the control group. There was no difference between the treatment groups.

Conclusion: Immune system plays critical roles in tissue repair and fibrogenesis. Results of our study demonstrated that azithromycin application reduced formation of peridural fibrosis in experimental laminectomy model in rats. Further studies with different dose regimes and different application routes are required to carry these results to an advanced level.     

Effect of Amniotic Membrane to Reduce Postlaminectomy Epidural Adhesion on a Rat Model

Objective

Epidural fibrosis and adhesion are the main reasons for post-laminectomy sustained pain and functional disability. In this study, the authors investigate the effect of irradiated freeze-dried human amniotic membrane on reducing epidural adhesion after laminectomy on a rat model.

Methods

A total of 20 rats were divided into two groups. The group A did not receive human amniotic membrane implantation after laminectomy and group B underwent human amniotic membrane implantation after laminectomy. Gross and microscopic findings were evaluated and compared at postoperative 1, 3 and 8 weeks.

Results

The amount of scar tissue and tenacity were reduced grossly in group of rats with human amniotic membrane implantation (group B). On a microscopic evaluation, there were less inflammatory cell infiltration and fibroblast proliferation in group B.

Conclusion

This experimental study shows that implantation of irradiated freeze-dried human amniotic membrane reduce epidural fibrosis and adhesion after spinal laminectomy in a rat model.     

Origin of the connective tissue scar in the transected rat spinal cord

The dense collagenous tissue that invades the site of spinal transection or hemisection in the rat constitutes a physical impediment to axonal regeneration and prevents functional reunion of the cut ends of the spinal cord. If this connective tissue response in the injured spinal cord were prevented, one barrier to regeneration would be eliminated, and we could better evaluate the role of other factors which affect regeneration of spinal axons. In the present study, the transected and hemisected spinal cords of rats were covered on the dorsal surface with a synthetic dural sheath composed of dacron and silicone. The dural sheath significantly reduced the invasion of connective tissue into the site of transection or hemisection. Because the sheath was located extradurally, we conclude that the fibroblasts which give rise to the connective tissue scar derive not from the dura mater but from connective tissue components of injured bone and muscle tissue adjacent to the spinal cord.     

The role of fibroblast growth factor-2 in healing the dura mater after inducing cerebrospinal fluid leakage in rats

We conducted a study to determine the effectiveness of topically applied recombinant mouse fibroblast growth factor-2 (FGF-2) in healing the dura mater in a rat with dura mater injury and cerebrospinal fluid leakage. Laminectomies were performed in 32 rats at the level of the L2–L4 vertebrae, and a dura mater defect was created. Sixteen rats were treated postoperatively with locally applied recombinant mouse FGF-2, and 16 animals received normal saline. FGF-2 effects on dura mater healing, cerebrospinal fluid leakage, and wound healing were assessed at 3 and 6 weeks postoperatively. The extent of dura mater healing was evaluated by histological analysis. We found that dura mater healing was significantly increased (p < 0.05) in rats treated with FGF-2 compared with rats in the control group. In this experimental model, locally applied FGF-2 effectively increased dura mater healing and induced no side effects.