保留黄韧带预防模型兔腰椎椎板切除后硬脊膜粘连.

BACKGROUND: Formation of scar tissue and the consequent formation of adhesions with dura and nerve root is an important factor for postoperative outcomes of laminectomy. How to reduce or prevent the adhesion or scar formation has been paid much attention in the clinic. OBJECTIVE: To explore the effect of preserving the ligamentum flavum on preventing dural adhesions after laminectomy in lumbar surgery. METHODS: Forty New Zealand white rabbits were randomly divided into ligamentum flavum resection group and ligamentum flavum preservation group (n=20 per group). All animals underwent L4-5 laminectomy, simulating nucleus pulpotomy. Postoperative dural adhesion was assessed according to Rydell-balazs and Nuss-baum criteria. RESULTS AND CONCLUSION: The operations were successfully completed, and there was visible scar in the operation area in the ligamentum flavum preservation group, the dura adhesion was easy to be separated bluntly from surrounding tissue. In the ligamentum flavum resection group, the scar tissue around the dura was very dense and the dural adhesions were serious, even osteoid was observed. The Rydell-balazs and Nuss-baum scores in the ligamentum flavum preservation group were significantly lower than those in the ligamentum flavum resection group (P < 0.05). To conclude, retaining the ligamentum flavum can reduce epidural scarring and adhesion of the dura to the surrounding tissue. [ABSTRACT FROM AUTHOR]