Pedicle Fat Grafts for the Prevention of Scar in Low-Back Surgery

Expanded polytetrafluoroethylene membrane for the prevention of peridural fibrosis after spinal surgery: a clinical study

“…The material that has been most commonly used as a barrier to peridural fibrotic invasion in patients undergoing spinal surgery is free and pedicled autologous fat grafts [6,9,15,16]. Fat grafts have been found to decrease dural adhesions or scar density in animal models more effectively than Surgicel [16], Avitene (Avicon, Fort Worth, Tex.)…”

“…Fat grafts have been found to decrease dural adhesions or scar density in animal models more effectively than Surgicel [16], Avitene (Avicon, Fort Worth, Tex.) [16], collagen [16], Gelfoam [9,16,34], or polyglactin 910 [25]. Clinically, the results achieved with fat grafts have been variable.…”

“…Laminectomy membrane appears in most patients who have undergone procedures involving exposure of neural elements [31]. In some patients, it may be responsible for recurrent pain after spinal surgery that necessitates a second operation [6,8,9,30,32]. Moreover, the presence of peridural fibrosis can increase the difficulty and risks involved in re-exposure during subsequent spinal procedures [18].…”

“…Several different materials and agents have been used experimentally and clinically in attempts to minimize peridural fibrosis, including autologous fat grafts [9,20], Abstract Peridural fibrosis developing after laminectomy may cause pain that can necessitate reoperation. Many materials have been used as a barrier to invasion of fibrous tissue into the vertebral canal, but the ideal material has not been found.…”

The barrier effect of laminae: laminotomy versus laminectomy

“…Later studies showed that autogenous free fat graft was more e ective in preventing scar tissue. 8,14,15 However, some cases were reported with symptomatic compres- Figure 1 Dura and spinal cord were involved by scar tissue after laminectomy (arrow) (grade 3) Figure 2 The adherence on laminectomy defect (arrow) (grade 2) Figure 3 Spinal neural elements were prevented after laminotomy (arrow) (grade 1) 24 However, other studies have indicated scar formation in a number of specimens even when fat graft was used. Barbera et al 11 performed an experimental study in dogs using various barrier materials and found good results with bone and methyl methacrylate.…”