Prospective Randomized Comparative Study to Evaluate Epidural Fibrosis and Surgical Outcome in Patients Undergoing Lumbar Laminectomy with Epidural Autologous Free Fat Graft or Gelfoam: A Preliminary Study
| Autor: | Ashwani Grover, B Paul Sudhakar John, Uttam George, Shivender Sobti, Sarvpreet Singh Grewal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Nerve root business.industry medicine.medical_treatment Laminectomy General Medicine Lumbar spinal canal stenosis medicine.disease Group B 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences 0302 clinical medicine Refractory Fibrosis medicine Original Article Neurosurgery epidural fibrosis business Contrast-enhanced magnetic resonance imaging Gelfoam 030217 neurology & neurosurgery Failed back syndrome free fat graft |
| Zdroj: | International Journal of Applied and Basic Medical Research |
| ISSN: | 2248-9606 2229-516X |
| Popis: | Introduction: Epidural fibrosis (EF) contributes to unsatisfactory relief of symptoms and failed back syndrome after spine surgery. EF around the nerve root can be more refractory to treatment than the original disc herniation itself. Reoperation on the scar can produce more scarring. Few studies have been conducted regarding the type of material to be used for decreasing EF. Materials and Methods: The prospective randomized comparative study was conducted in the Department of Neurosurgery and Radiodiagnosis, of a tertiary care hospital. Informed and written consent was obtained. Patients previously unoperated with symptoms and radiological features of lumbar spinal canal stenosis were included in the study. Fifteen patients were assigned to Group A (free fat graft) and 15 patients in Group B (Gelfoam group). Postoperatively, at 3 and 6 months, clinical outcome was evaluated and EF was assessed on CE-MRI. Results: Age and sex were comparable in both groups. The pain relief at 3 and 6 months was more in Group A as compared to Group B. In Group A, on CEMRI at 3 months, 87% of patients had none to mild fibrosis, with none had extensive fibrosis. The CEMRI at 6 months showed no increase in fibrosis. In Group B, 80% of patients had none to mild fibrosis at the end of 3 months. At 6 months, 13.3% patients had extensive fibrosis. The extent of EF was found to be statistically significant at 6 months postsurgery. Conclusion: Use of free fat graft at laminectomy site helps in reducing EF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|