The barrier effect of laminae: laminotomy versus laminectomy

Abstract

Study design: An experimental study to investigate whether replacement of the laminae (laminotomy) after subliminal procedures can prevent the invasion of scar tissue towards the dura. Setting: Izmir, Turkey. Methods: Laminectomy and laminotomy were performed at di erent levels on seven rats. Their spinal columns were investigated histopathologically after a period of 3 months. Results: The histopathological evaluation revealed that the dura and spinal cord were involved by scar tissue at laminectomy area. However, this invasion was not observed at laminotomy levels. This study showed the barrier e ect of laminae against ®broblastic activity. Conclusion:The barrier e ect of lamina may a ect the surgical outcome related to epidural ®brosis. Spinal Cord (2000) 38, 442 ± 444

Laminotomy in adults: technique and results

“…Kawahara, Hida, Benglis [20] all confirmed that laminotomy actually reduced the risk of epidural scarring in their series of laminotomies. Beside these clinical experiences, In 2000, Yucesoy [39] published convincing experimental evidence about the barrier effect of the laminae in preventing the post-laminectomy membrane. Sani [30] analyzed the clinical significance of the post-laminectomy membrane or epidural scarring: in contrast to Hara, they concluded that these were never responsible for any neurovascular compression.…”

Comparative Preventive Efficacy of Recombinant Tissue Plasminogen Activator (rt-PA), Urokinase, Hyaluronic acid and Enoxaparin in Post Laminectomy Epidural Fibrosis in Rats

“…The review of the literature reveals the presence of many hypotheses and treatment attempts regarding epidural fibrosis (3,4,(18)(19)(20). Epidural fat destruction, local hematoma, migration of fibroblasts from the raw surface of the erector spinae musculature was stated the source of postoperative scar tissue (11)(12)(13)22). Furthermore, foreign body reaction from surgical swab debris, as well as a systemic fibrinolytic defect, has also been reported as possible etiologies of post laminectomy scar formation (4,12).…”

Prevention of spinal epidural fibrosis by recombinant tissue plasminogen activator in rats

“…3,5 Fibroblasts, originating from the overlying muscles and following extension of postoperative haematoma in to the vertebral canal, cause epidural fibrosis. [9][10][11] The migration of fibroblasts from the raw surface of the erector spinae musculature was stated as the source of postoperative scar tissue. 9 Furthermore, foreign body reaction from surgical swab debris, as well as a systemic fibrinolytic defect, has also been reported as possible aetiologies of postlaminectomy scar formation.…”

“…[9][10][11] The migration of fibroblasts from the raw surface of the erector spinae musculature was stated as the source of postoperative scar tissue. 9 Furthermore, foreign body reaction from surgical swab debris, as well as a systemic fibrinolytic defect, has also been reported as possible aetiologies of postlaminectomy scar formation. 5,12 Prevention of postlaminectomy scarring has been attempted using different mechanical barriers, chemical regulation of scar formation and prevention of local Figure 1 Laminectomy site with thick, dense collageneous scar extending into the bone defect (thick arrow) and diffuse attachments to the dura (thin arrow) (H&E Â 40) Figure 2 Photomicrograph showing section of laminectomy site with moderate fibrous tissue presence in control rat (H&E Â 40) rt-PA in experimental epidural fibrosis S Kemaloǧlu et al haematomas.…”

“…The objective criteria of adhesion were graded as in Table 1. 9 Additionally, we also used a scoring system for gross evaluation of peridural fibrosis to investigate the quantity of the peridural fibrosis with another scoring system as stated in a previous report in the literature 6 ( Table 2).…”