Histopathological Study of the Effects of Dura Adhesive Agents Used in Spinal Surgery Practice on Spinal Epidural Fibrosis in Experimental Animal Model

Objective

Histopathological examination of the effects of Tisseel, Cova, Glubran and Coseal, which are used for sealing purposes in spinal surgery practice, on epidural fibrosis is aimed.

Methods

Forty Sprague Dawley rats were randomly divided into five groups in our study as Group 1 (n=8) control group (Laminectomy); Group 2 (n=8) Cova group (Laminectomy + Cova); Group 3 (n=8) Tissel group (Laminectomy + Tisseel); Group 4 (n=8) Coseal group (Laminectomy + Coseal); and Group 5 Glubrane group (Laminectomy + Glubrane). Control group was only applied laminectomy. After laminectomy to other groups, Cova was applied to the 2nd group, Tissel to the 3rd group, Coseal to the 4th group and Glubran to the 5th group in surgical fields. After the rats were monitored in separate cages for 6 weeks after the operation, the relevant spinal level was extracted and the samples were examined histopathologically and the results were evaluated statistically.

Results

It was found that there was a statistically significant difference in Tisseel and Glubran groups in terms of fibrosis grading compared to the control group, and this had a positive effect on fibrosis. Compared to the control group, there was no statistically significant difference on fibrosis in Cova and Coseal groups.

Conclusion

As dura adhesive agents used in spinal surgery practice did not increase spinal epidural fibrosis statistically significantly, we concluded that these products can be used safely during spinal surgery if necessary.

The histopathological effects of reabsorbable polyethylene glycol hydrogel (Coseal) on epidural fibrosis in an experimental postlaminectomy model in rats

Background/aim

To investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal) on epidural fibrosis (EF) following laminectomy in rats.

Materials and methods

A total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF.

Results

The results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3.

Conclusion

Intraoperative Coseal, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.