预防椎板切除术后硬膜外疤痕粘连的实验研究

An experimental study of preventing extradural scar adhesoions after laminectomy

对１０只山羊在暴露的硬膜表面分别行不相连续的椎板切除术。Ｌ_２～３水平为空白对照（Ｃ点），Ｌ_４～５水平涂硅油（Ｂ点），Ｌ_６～Ｓ_１水平涂硅油阿霉素油剂（Ａ）点。术后动态观察１６周脊柱横断面变化，显示Ａ、Ｂ两点疤痕与硬膜均无粘连，Ｃ点则紧密粘连。与Ｂ、Ｃ两点比较，Ａ点各期疤痕均薄，成熟晚。结果表明：医用２０１甲基硅油能有效地预防硬膜与疤痕粘连，对机体无毒、无副作用。阿霉素可减少疤痕生成，延缓疤痕成熟，但对神经可产生毒性或刺激作用。

One of the major failure causes of laminectomy is the dense fibrosis scar tissue adherent to the exposed dura and nerve roots. In the experiment,three level noncontiguous laminectomies were performed on ten goats. The exposed dura at each of the three levels, was treated as follows : the level of L2～3 site was left uncoverd as the control site (C), L4～5 smeared with silicone (B), and L6～S1 smeared with mixtured silicone and adriamycin(A). The observation of the spinal transverse sections was done after 16 weeks. The resuhs showed that there were no scar adhered to the dura at sites A and B,but adhesions at sites C. The scars were thinner and later mature in sites A than in sites B and A. It is concluded that silicone is effective in preventing extradura adhesion from the scar after laminectomy, none toxic and free of side effects. Adriamycin may reduce the scar formation,but delay the scar maturity and irritate the nerves.Author′s address Department of Orthopaedics, Hebei Provence Public Hosprtal, Shijiazhuang. Hebei,050051