| Objective: To observe and evaluate the intervention effect of AngelicaInjection from epidural infusion on epidural scar formation and the epiduraladhesions of laminectomy animal models, and explore its fundtion mechanism.Method:48adult and healthy New Zealand white rabbits are divided randomlyinto4groups,with12in each group.group A: blank group; group B:modelgroup(the physiological saline group); group C: control group(sodiumhyaluronate group); group D:experimental group(Angelica injectiongroup).Laminectomy was performed on L3spine and both sides of vertebrallamina,and resulted in the status of0.5cm×0.5c m lamina defect. Afterstopping bleeding and irrigating the incision during operation, Group A:Notdo anything except sewing up wound.Group B:carefully clip suitable size ofgelatin sponge and administrate physiological saline of1ml on the exposedarea of epidural; group C: carefully clip suitable size of gelatin spongeevenly coated with sodium hyaluronate0.1ml gently on the exposed area ofepidural; group D: carefully clip suitable size of gelatin sponge andadministrate Angelica in1ml gently on the exposed area of epidural;Experimental animal were put to death with air embolism method after2,4and6weeks later. Ticked the spine of operation period to observe and assessadhesion degree, histological observation and determine the content ofhydroxyproline in scar tissue.Results:48New Zealand rabbits were involved in the result analysis:1.Grossobservation:the degree of adhesion of the blank group and is the most serious,followed by the model group,adhesion of the experimental group and the controlgroup were lighter.2.Histological observation: After two weeks, large Numbersof Fibroblast cells hyperplasia and inflammatory cells infiltrated In theepidural of group A, B, lighter group B, group C, D shows A small amount offibroblasts, group A had significant difference with group B, C, D (P <0.05),group B and groups C, D had significant difference (P <0.05), group C and group D no had significant differences (P>0.05); After4weeks, In theepidural of group A there were many fibre, structure compact, epidural spacedisappeared and inflammation was heavy, In the epidural of group B there werea lot of Fibroblast cells hyperplasia, epidural space narrow, In the epiduralof group C,D there were visible sparse fibre, existence of epidural space.significant differences between them (p <0.05). Group A and group B, groupC and group D had no significant difference (p>0.05), group C, D and A, Bgroup had significant difference (p <0.05); After six weeks, In the epiduralof group A, B there were A lot of fiber organization filling, collagen fiberdensity and epidural adhesion was more widely than4weeks, part of Fibroblastcells In the epidural of group C turned into fiber cells, structure sparse,visible light membrane adhesion, Compared with group C, at the6week,groupD had more fibrous tissue formation, structure slightly dense, extensive duraland scar tissue adhesion（P＜0.05）.3.Determination of hydroxyproline content:Group D had obvious differences with group A and group B at each time point（P＜0.05）, in Experimental4weeks there was no significant difference betweenC group（P＜0.05）, at6weeks and C resulted in significant difference（P＜0.05）.Conclusion: In4weeks,angelica injection and sodium hyaluronate canreduced epidural scar adhesion, its mechanism might be related to theacceleration of local hematoma absorption and inflammatory substancesscavenging,inhibiting proliferation of fibroblast cells and reducing theextracellular matrix synthesis. But as time prolonged, compared with sodiumhyaluronate, angelica injection has no obvious advantages on prevention ofepidural scar formation and dural adhesion after laminectomy.Thus，angelicainjection can not be used as the first choice for the prevention of FBSS. Toapply it to clinical work still requires a lot of researches and experiments. |
PDF Full Text Request