Objective To compare the effect of topical application of poly-(DL-lacitc acid) (DL-PLA) film and mitomycin C (MMC) alone, as well as the combination of DL-PLA film and MMC in inhibition of rat epidural adhesions after laminec-tomy with 7. OT micro-MRI. Methods Sixteen SD rats were randomly divided into 4 groups (each n=4) according to epidural local application of drugs after laminectomy: Group A: MMC 0. 67 mg/ml alone; group B: Saline and 0. 05 mm DL-PLA films group C: Combination of MMC 0. 67 mg/ml and 0. 05 mm DL-PLA film; group D (as control) : Saline alone. Rats were killed and MR scan was performed 4 weeks later to measure the scar tissue areas and adhesions between the dura mate of spinal cord and other tissues with stereoscopic microscope. Results The epidural scar tissues were not very dense, the scar areas reduced and had small quality of adhesions with the dura mate of spinal cord in Group A and B. The scar tissues were less dense and the scar areas were smaller in Group C. Group D had dense epidural scar tissue, larger scar areas and close-up adhesions with the dura mate of spinal cord. Conclusion Topical application of concentration of 0. 67 mg/ml MMC or 0. 05 mm DL-PLA film can reduce epidural scar tissue. The effect of inhibition adhesions would be more pronounced when they were both used.%目的 应用7.0T micro-MR比较单独应用丝裂霉素C(MMC)、消旋聚乳酸(DL-PLA)膜以及二者联合应用(MMC+DL-PLA膜)时抑制大鼠椎板切除术后硬膜外粘连的效果.方法 将16只SD大鼠随机分为4组,每组4只,椎板切除术后于硬膜外给予不同局部处理:单纯MMC组局部应用MMC 0.67 mg/ml;单纯DL-PLA膜组给予生理盐水和0.05 mm厚DL-PLA膜；MMC+ DL-PLA膜组给予MMC 0.67 mg/ml和0.05 mm厚DL-PLA膜；对照组单纯应用生理盐水.术后4周处死大鼠,分别行7.0T micro-MR扫描及瘢痕组织面积测定,并于镜下观察硬脊膜与后方瘢痕组织粘连情况.结果 单纯MMC组和单纯DL-PLA膜组硬膜外瘢痕组织较疏松,瘢痕面积小,与硬脊膜部分粘连.MMC+ DL-PLA膜组硬膜外瘢痕组织较疏松,瘢痕面积更小,与硬脊膜未形成明显粘连.对照组标本硬膜外瘢痕组织致密,瘢痕面积大,与硬脊膜形成紧密粘连.结论 局部单独应用浓度为0.67 mg/ml的MMC或0.05 mm厚的DL-PLA膜均能减少硬膜外瘢痕组织增生,二者联合应用时效果更显著.
展开▼
