Turkish Neurosurgery 2001 , Vol 11 , Num 1-2
M. Faik ÖZVEREN1, Cengiz S. TÜRKMEN2, Canan TANIK3, İbrahim M. ZİYAL4, Fatih S. EROL1
1University of Fırat School of Medicine, Department of Neurosurgery, Elazığ
270. Yıl Rehabilitation Hospital, Department of Neurosurgery, İstanbul
3Şişli, Etfal Hospital, Department of Pathology, İstanbul
4The Abant İzzet Baysal University School of Medicine, Department of Neurosurgery, Düzce, Turkey
The aim of this study was to investigate whether expanded polytetrafluoroethylene (ePTFE) grafts prevent peridural fibrosis (PF). Seven adult dogs were anesthetized with an intramuscular injection of xylazine + ketamine HCI, and were operated on between L5 and S1 via a posterior approach. Total laminectomies were performed at L5, L6, and L7, and the spinal dura mater and associated tissues from L5 to S1 were exposed. In the control region of the spine (L5-L6), we performed a discectomy and removed the ligamentum flavum and epidural fat. In the next section (L6L7), we performed a discectomy but left the !igamentum flavum and epidural fat tissue intact, forming a pediculated fat graft in the laminectomy defect. At L7-S1, we performed the same procedures as were done at the previous level, but inserted an ePTFE graft in place of the ligamentum flavum and fat graft. Three dogs were sacrificed after 3 months, anather two dogs after 6 months, and the last two after 9 months. Histopathological evaluation of tissues from the animals sacrificed at 3 months revealed +3 grade PF at the control level, and +2 grade PF at the level with the preserved ligamentum flavum and fat graft in all three dogs. At the ePTFE graft level, two animals showed + 2 grade PF and one showed +1 grade PF. Specimens from the four dogs sacrificed at 6 and 9 months showed +3 grade PF at all levels. The results demonstrated that ePTFE grafts do not effectively prevent PF throughout the 9-month period after laminectomy with discectomy. Keywords : Expanded polytetrafluoroethylene graft, fat graft, laminectomy membrane, peridural fibrosis
Corresponding author : M. Faik Özveren, fozveren@yahoo.com