Is the use of hemostatic matrix (Floseal) and alkylene oxide copolymer (Ostene) safe in spinal laminectomies? Peridural Şbrosis assessment

Abstract

Objective: Failed Back Syndrome (FBS) is unacceptable relief of pain or recurrence of symptoms in patients after spinal surgery, such as laminectomy. One possible cause of FBS is periduralŞbrosis (PF). PF isthe overproduction of scar tissue adjacent to the dura mater. Bleeding can cause PF after laminectomy.Ostene is an alkylene oxide copolymer material used to stop bleeding from bony surfaces. Floseal is agelatin thrombin matrix sealant used to assistŞbrin formation and to promote coagulation.Methods: Total of 32 female SpragueeDawley rats were evenly allotted to 4 experimental groups:laminectomyonly,laminectomy? Floseal (Baxter International, Inc., DeerŞeld, IL, USA), and laminectomy ? Adcon-L (aapImplantate AG, Berlin, Germany). After performing total laminectomy, agents were placed over duramater. Spinal column of test subjects was harvested 6 weeks after laminectomy. Histopathological examination of samples was based on Masson's trichrome and hematoxylin and eosin staining. PF observedin the groups was graded using system previously described by He et al. Statistically signiŞcant p valuewas deŞned as p < 0.005.Results: Present study revealed that Adcon-L, Ostene, and Floseal groups had reduced PF compared withlaminectomy only group (p¼ 0.001). Comparison of Ostene and Floseal groups with Adcon-L groupyielded no signiŞcant difference.Conclusion: Reoperation as result of FBS has greater risk and often has poor outcome; surgeons musttake precautions to avoid FBS, such as careful selection of appropriate patient and operation technique.Ostene and Floseal may be applied and left in the operationŞeld safely during laminectomy to reduceoccurrence of PF after procedure.© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd.