Experimental Study Of Reservation Flaval Ligament On Prevention Of Peridural Adhesion After Operation On Lumbar Disc

Object:Through an experiment in rabbits, to evaluate the role of reservation flaval ligament usingdifferent methods to prevent the epidural adhesion by observing the morphological changes.We can judge the role of reservation flaval ligament to prevent the epidural adhesion andprovide experiment evidences for clinic.Material and Methods:45 adult rabbits were divided into three groups: Group A (treated with no reservation offlaval ligament), Group B (treated with reserving half flaval ligament), and Group C (treatedwith reserving the complete flaval ligament). Every group has 15 rabbits. At the 2th,4th and8th weeks, the samples were obtained for gross observation, histological examinations, andthe images were analysed by computer. The data were processed using SPSS11.5.Result:Gross Observation: At the 2th postoperative week, there was a little adhesion formed ingroup A and B and no obvious adhesion formed in group C. The difference in the group C andA, C and B was significant(P＜0.05).There was no obvious difference in the group A andB(P＞0.05). At the 4th postoperative week, there was a lot of adhesion formed, its constructionwas hard and some peridural adhesion extended to side in the group A. Some fibroscar wasfound and its construction was loosen in the group B. Little fibroscar was found in the groupC. The difference was significant in the group A and B(P＜0.05),B and C (P＜0.05),and thedifference in the group C and A was very significant(P＜0.01). At the 8th postoperative week,find obvious adhesion formed in in the group A and B. Most of the group A and some ofgroup B, fibroscar extended to side and nerve root. Little loosen fibroscar was found in thegroup C. The difference was significant in the group A and B(P＜0.05),B and C (P＜0.05),and the difference in the group C and A was very significant(P＜0.01).Histological Examinations: At the 2th postoperative week, In the groupA, inflammaforyreaction and fibroblast were obvious, can find plenty of blood vessel and fibroblast. In thegroup B, inflammafory reaction and fibroblast were less than group A, no obvious reaction inthe group B. There was no significant difference between the group A and B (P＞0.05), thedifference was significant in the group C and B (P＜0.05),C and A(P＜0.01). At the 4thpostoperative week, adhesion was obvious in the group A and B, and its construction wascompact, the space outside dural was disappear in the group A. A little loosen adhesion wasfound in the group C, and the space outside dural was integrity. The difference was verysignificant in the group A and C(P＜0.01), B and C (P＜0.01), and the difference in the group Aand B was significant(P＜0.05). At the 8th postoperative week, adhesion was more serious inthe group A and B,and is little in the group C. The statistical result was as the same as the 4thpostoperative week.Images analysis: The difference was very significant in the groups at 2th, 4th and 8thweeks(P＜0.01). With time passing, the ratio became larger and larger in the same group.Conclusions:1. Reserving the complete flaval ligament can significantly prevent the peridural adhesionfrom the back as a barrier, and can reduce the adhesion formed.2. Reserving half flaval ligament can prevent the peridural adhesion from the back, but it isinferior to reserving the complete flaval ligament.3. The operation of reserving the complete flaval ligament is easy to do, don't needextraneous implants, don't increase economical burden. It will be adopted widely in clinic.4. we can carry on the experiment on the molecular biology level and provide moreexperiment evidences for clinic in the future.