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  • Effects of Two New Hemostatic Agent in Preventing Epidural Fibrosis After Laminectomy in Rats

    Final Number:

    Rafet Özay MD; Osman Yüksel Yavuz; Mehmet Erhan Türkoglu MD; Abit Aktas; Funda Yigit; Haci Mustafa Özdemir; Zeki Sekerci

    Study Design:
    Laboratory Investigation

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: One of the most important reason of the failed back surgery is epidural fibrosis (EF). The epidural scar tissue has organized at postoperative 6-24th week. Management of symptomatic epidural is challenging and, both conservative and surgical treatments have high failure rate. Our purpose is to investigate the effects of two new hemostatic agents [Ankaferd Blood Stopper (ABS) and Microporous Polysaccharide Hemospheres (MPH)] in preventing of EF on rat laminectomy model.

    Methods: 18 rats were divided to used in three as follow. Group 1 (control), group 2 (ABS) and group 3 (MPH). L4-6 skin incision and L5 total laminectomy was performed. In the control group only a laminectomy was performed, whereras in treatment groups ABS and MPH were use. After controlling bleeding with cotton paddies at laminectomy site; in the ABS group 1cc ABS (Ankaferd), and in the MPH group (n = 6) 1 puff MPH (Arista) were applied and layers were closed in anatomical layer. 6 weeks later, the rats were sacrificied and the spine was removed in en block fashion from L4 to L-6 level. EF and arachnoidal involvement (AI) at laminectomized levels were calculated according to He et al. scoring system Table-1) and the fibroblasts (FN) were counted (with steorologic method).

    Results: The scores in the MPH group (EF and AI score, and about FN were statistically significantly lower than the control group (Table-2) (Figure 1-2). In the ABS group all values were statistically significantly lower than control group (Table-2) (Figure 1-3).

    Conclusions: Our study demonstrated that, MPH and ABS can be preventive especially in leaking hemorrhages. They inhibit the formation of EF after lumbar disc surgery by providing excellent hemostasis.

    Patient Care: Present study will help to prevent formation of EF after lumbar microdiscectomy; so that it will aid for decreasing the total costs of patient treatment care and workforce loss.

    Learning Objectives: MPH and ABS can be preventive especially in leaking hemorrhages and they inhibit the formation of EF.


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