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THE LAMINECTOMY MEMBRANE

Studies in its Evolution, Characteristics, Effects and Prophylaxis in Dogs

Henry LaRocca 1; and Ian Macnab 1

1 Division of Orthopaedic Surgery, Tulane University, New Orleans; Division of Orthopaedic Surgery, the Wellesley Hospital, Toronto, Ontario

1 . Standard lumbar laminectomy was performed at multiple levels in thirty dogs, and manipulations were carried out in the spinal canal to observe their effects on periradicular adhesion formation. The canal was scarified, packed with Gelfoam, or treated with three varieties of Silastic membranes. The results were serially assessed from three days to twelve weeks by gross observation, nerve conduction studies, histological examination of transverse sections of the spine, myelin study of lumbar roots and micropaque study of the arterial supply to the roots.

2. The results were consistent biologically. The principal source of scar is dorsally in the fibrous tissue elements of the erector spinae muscle mass. This scar, the laminectomy membrane, covers the laminectomy defect and extends into the canal bilaterally to adhere to the dura and nerve roots.

3. Gelfoam does not contribute to scar formation, but instead acts as an effective interposing membrane. Silastic membranes are capable of providing protection against nerve root adhesions without interfering with the anatomical or physiological integrity of the nerves.

4. Certain clinical implications of the study are discussed.

Note:

This experimental study was carried out with the aid of a grant from the Workman's Compensation Board of Ontario.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General