The Formation of Epidural Fibrosis in Case of Damage to the Dura Mater After Laminectomy

Животенко, А. П.; Гольдберг, О. А.; Sorokovikov, V. A.; Кошкарева, З. В.; Shurygina, I. A.

doi:10.17513/spno.29118

Cited by 4 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Однако широкое распространение кардиохирургических операций неизбежно приводит к усугублению проблемы, связанной с осложнениями оперативных вмешательств -повышению частоты послеоперационных спаечных процессов в полости перикарда. Формирование послеоперационных спаечных процессов актуально для многих сфер современной хирургии: в абдоминальной хирургии [2][3][4], оперативной гинекологии, нейрохирургии [5].…”

Section: хирургия Surgeryunclassified

Prospects for prevention of adhesion process during cardiac surgical interventions

Шурыгин

Shurygina

2021

Acta biomedica scientifica

View full text Add to dashboard Cite

The article is devoted to the problem of prevention of adhesions in cardiac surgery. It was determined that the problem is urgent due to the increase in the number of heart surgeries. The formation of adhesions is a reaction of the body after surgery, which is a stage of healing and partly performs a protective function. Nevertheless, the presence of adhesions violates the mechanical properties of the heart, negatively affects central hemodynamics, complicates the surgeon’s task during repeated surgical interventions and increases the risk of repeated operations.It has been shown that at present, for the prevention of adhesions, researchers tend to use biodegradable barrier materials with biocompatibility and the ability to dissolve after performing the barrier function. The main anti-adhesion agents used in cardiac surgery are membranes and gels. The requirements for an “ideal” agent for the prevention of adhesion were determined: biocompatibility, no irritating effect, no effect on wound healing, suppression of the growth of connective tissue in the pericardium.Conclusions. Until now, none of the funds has all the necessary qualities to prevent adhesion in the pericardium. Therefore, the search for effective methods for the prevention of postoperative adhesions remains relevant for cardiac surgery.

show abstract

Section: хирургия Surgeryunclassified

Prospects for prevention of adhesion process during cardiac surgical interventions

Шурыгин

Shurygina

2021

Acta biomedica scientifica

View full text Add to dashboard Cite

show abstract

“…При повторных операциях на позвоночнике, на ранее оперированных уровнях рубцово-спаечный процесс в эпидуральном пространстве встречается в 100 % случаев и является частой причиной интраоперационных осложнений (кровотечение, повреждение спинномозгового корешка и твёрдой мозговой оболочки с последующей ликвореей), следствием чего являются неудовлетворительные исходы хирургического лечения с формированием стойкого болевого синдрома, псевдоменингоцеле, адгезивного арахноидита и т. д. [1,2,3]. В таких условиях хирургу приходится работать на рубцово-изменённых тканях, с которыми могут быть тесно спаяны сосудистоневральные образования позвоночного канала, более чувствительные к повреждениям во время их тракции на этапе хирургического вмешательства.…”

Section: Introductionunclassified

“…В таких условиях хирургу приходится работать на рубцово-изменённых тканях, с которыми могут быть тесно спаяны сосудистоневральные образования позвоночного канала, более чувствительные к повреждениям во время их тракции на этапе хирургического вмешательства. Данные повреждения не всегда можно визуализировать во время оперативного вмешательства даже с использованием современного оптического увеличения и интраоперационного нейромониторинга [2,4]. По данным литературы известно, что при каждой последующей повторной операции снижается процент удовлетворительных исходов хирургического лечения: так, при первичных оперативных вмешательствах процент удовлетворительных исходов лечения составляет более 50 %, при вторичных -не более 30 %; при третьих -15 %; при четвёртых -5 % [1].…”

Section: Introductionunclassified

“…№ 653н) отсутствуют рекомендации по профилактике эпидурального фиброза, что увеличивает риск неудовлетворительных исходов и интраоперационных осложнений при повторных операциях. Эпидуральный фиброз является одной из основных причин развития синдрома неудачно оперированного позвоночника (FBSS) и важной и нерёшенной на сегодняшний день проблемой в хирургии позвоночника [1,2]. Эпидуральный фиброз и адгезивный арахноидит не классифицируются по МКБ 10 [5].…”

Section: Introductionunclassified

“…Zhivotenko A.P. 1 , Sorokovikov V.A.1,2 , Koshkareva Z.V.1 1 Irkutsk Scientific Centre of Surgery and Traumatology (Bortsov Revolyutsii str. 1, Irkutsk 664003, Russian Federation)damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case)

Животенко

Sorokovikov

Кошкарева

2020

Acta biomedica scientifica

View full text Add to dashboard Cite

The work presents a rare clinical case of adhesive arachnoiditis, which developed against the background of epidural fibrosis during repeated surgical interventions. The cicatricial adhesion in the epidural space is formed in 100% of cases after surgery and is a frequent cause of intraoperative complications during repeated surgical interventions (bleeding, damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc. The cicatricial adhesion in the epidural space is the main reason for the development of failed back surgery syndrome (FBSS), which today is an important and unresolved problem in spinal surgery. The epidural, as well as the subdural and subarachnoid space of the operated spinal motor segment of the spinal canal can be involved in the cicatricial adhesion, as it is shown in our clinical example. In this regard, it is important to prevent the development of the cicatricial adhesion in the epidural space during primary spinal surgeries, since with the increase in life expectancy of the population and increase in surgical activity during spinal surgeries, the patient can be operated repeatedly. Consequently, the question arises of preventing the formation of the cicatricial adhesion in 100% of cases with each surgical intervention, since the formed cicatricial adhesion in the epidural space does not have effective methods of conservative and surgical treatment and worsens favorable and satisfactory forecasts of surgical treatment for repeated surgical interventions.

show abstract

Morphological Patterns of Development and Prevention of Experimental Epidural Fibrosis

Shurygina¹,

Животенко²,

Гольдберг³

et al. 2022

View full text Add to dashboard Cite

Objective: To identify the morphological patterns of development and prevention of experimental epidural fibrosis based on the shape of the dural sac in the area of laminectomy. Methods: Male Wistar rats aged 4-5 months underwent laminectomy at the level of L6-S1. The animals were divided into two groups with 7 animals per group. In the main group (Group A) the animals were treated with Antiadhesin® gel applied to the wound to prevent the development of epidural fibrosis, while in the group of comparison (Group B), the gel was not applied. Another 7 healthy animals were used as a control group. The animals were taken out of experiment on the 28th day. Histological slides stained with hematoxylin-eosin were used to measure the width and length of the dural sac, its area, perimeter, and calculate its deformity index. Results: In group B at the level of laminectomy, the ratio of the width to length of the dural sac was significantly higher than in the control group (p<0.05), mainly due to the enlarged width, while the length did not change significantly. In group A these parameters did not differ from the control group, which indicated that application of Antiadhesin® prevented formation of a connective tissue scar which could compress the dural sac and cause its deformation. In group A in the area of surgical intervention, granulomas with Pirogov-Langhans cells were detected, both in the soft tissues and in the lumen of the spinal canal. These findings in perioperative tissues might be related to biocompatibility and indicate their reaction to a gel as a foreign body. Conclusion: In clinical practice optimal materials for the prevention of epidural fibrosis are missing. There is an obvious need for further research in order to obtain implants capable of inhibiting and reducing the formation of epidural fibrosis. Keywords: Dura mater, epidural fibrosis, prevention, experiment, laminectomy, Antiadhesin®.

show abstract

The Formation of Epidural Fibrosis in Case of Damage to the Dura Mater After Laminectomy

Cited by 4 publications

References 0 publications

Prospects for prevention of adhesion process during cardiac surgical interventions

Prospects for prevention of adhesion process during cardiac surgical interventions

Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case)

Morphological Patterns of Development and Prevention of Experimental Epidural Fibrosis

Contact Info

Product

Resources

About