An Experimental Study On Prevention Of Scar Formation After Laminectomy By A SMB-Carbomer Gel

An Experimental Study on Prevention of Scar Formation After Laminectomy by a SMB-Carbomer Gel Objective: The mechanism and the effects of the prevention of scar formation after Laminectomy by a SMB-Carbomer Gel is explored through an experiment in rabbits. Methods: The Carbomer Gel and SMB-Carbomer Gel were acquired from the dry Carbomer-940 powder and SMB powder . Laminectomy was performed in L3 . L6 on 36 rabbits which had been divided into 4 groups randomly and resulted in the status of 1 OX5mm lamina defect. Apply different treatments on the 4 groups, group A left uncovered, group B covered with Carbomer Gel, group C with 2% sodium hyaluronate, and group D with SMB-Carbomer Gel. Take out integral specimens of the 2 segments at the 4^th 6^th and postoperative week to do the following procedures respectively: grossly anatomical evaluation and appraise the degree of scar adhesion grossly, histological examination on the conditions of epidural adhesion and inflammation of each group after H.E dyeing, then imaging analysis for measuring the thickness of the scar. In addition, one specimen of each group was inspected with electron transmission microscopy at the it's postoperative week. Results: 1.5% Carbomer Gel and 1.3% SMB-Carbomer Gel were produced respectively. At each time spot, severe peridural adhesion was formed in all the specimens of group A, but peridural adhesion was formed only in parts of those of group B and C, whereas no obvious adhesion in those of group D. Statistical analysis showed that, at each time spot, there were statistical difference between the thickness of adhesion on the specimens of group A and that on the specimens of all other groups; that no such difference between group B and group C; and that great difference lay in between that of group B and C and that of group D. Plus, the degree of adhesion has statistical difference between group C and D could be seen. The actively proliferating fibroblast could be observed by microscopy at 4- postoperative week in group A,B and C, while, in group D, the proliferation inactive. Conclusion: 1. SMB-Carbomer Gel has been proved to have the best effect in preventing the epidural scar formation after Laminectomy. 2. SMB-Carbomer Gel has the best biological compatibility with the tissues. 3. The preventive mechanism of SMB-Carbomer Gel has double protective effects, i.e. the three-dimension physical protection by the viscous semi-fluid property and the chemical protection of the SMB Which inhibitS the fibroblast from proliferation.4. The SMB-Carbomer Gel achieves better effect than the HA inpreventing the formation of adhesion.