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The prevention of peridural adhesions

A COMPARATIVE LONG-TERM HISTOMORPHOMETRIC STUDY USING A BIODEGRADABLE BARRIER AND A FAT GRAFT

J. J. Quist, MD, Senior Resident in Orthopaedics1; W. J. A. Dhert, MD, PhD, Head of Orthopaedic Research1; B. P. Meij, DVM, PhD, Diplomat ECVS2; W. J. Visser, DDS, PhD, Histopathologist1; F. C. Oner, MD, Consultant Orthopaedic Surgeon1; H. A. W. Hazewinkel, DVM, PhD, Diplomat ECVS2; and A. J. Verbout, MD, PhD, Professor of Orthopaedics and Head of Department1

1 University Cluster of Orthopaedics, Utrecht University, University Hospital, Room G05.228, PO Box 85500, 3508 GA Utrecht, The Netherlands.
2 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands.

Correspondence should be sent to Dr W. J. A. Dhert.

We studied peridural fibrosis in 16 dogs after laminectomies at the L2, L4 and L6 levels. They received either a free fat graft, a biodegradable mechanical barrier (polyethylene oxide (PEO)/polybutylene terephthalate (PBT) copolymer), or no treatment. The animals were killed after 4, 12, 26 and 52 weeks.

Histomorphometry showed extensive and consistent peridural fibrosis in control and PEO/PBT groups. Fat grafts produced significantly less fibrous tissue, but the presence of the fat graft in the bony defect prevented closure. Degradation of the PEO/PBT barrier resulted in the formation of more fibrous tissue.

We conclude that up to one year a free fat graft is effective in reducing the amount of peridural scarring.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General