Chitosan Dextran gel as an anti adhesion agent in a postlaminectomy spinal sheep model. (June 2017)

• Record Type: Journal Article
• Authors: Rajiv, Sukanya; Drilling, Amanda; Bassiouni, Ahmed; Harding, Marguerite; James, Craig; Robinson, Simon; Moratti, Steve; Wormald, Peter-John
• Is Part Of: Journal of clinical neuroscience. Volume 40(2017:Jun.)
• Page Start: 153
• Page End: 156
• Publication Date: 2017-06
• Subjects: Chitosan -- Gelfoam -- Sheep -- Laminectomy -- Adhesions -- Spine; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2017.02.010
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Chitosan Dextran gel's role as anti adhesion agent in a sheep spinal surgery model has been studied. Chitosan Dextran gel is also a hemostatic agent. It is safe and effective. Abstract: Introduction: Post-operative peridural adhesions increase morbidity after neurosurgical procedures. Aim of this study is to assess safety and efficacy of Chitosan-Dextran (CD) gel as an anti–adhesion agent in a spinal laminectomy sheep model. Methods: Eighteen sheep were used in this study with 6 animals in each treatment arm (namely, CD gel, Gelfoam paste and normal saline control). Posterior lumbar laminectomy was performed in all animals and the dura was exposed intact. Test agents were applied over the exposed dura and the wound was closed in layers. Sheep were euthanized at the end of three months. MRI spine was performed after euthanasia to assess epidural fibrosis. Adhesion in the spinal specimen was assessed by Peel test and histopathology was used to assess safety of the agents. Results: Average scores for the Peel test for CD gel, Gelfoam and normal saline control groups were 1.16 (95% CI, 0.5–1.7), 1.5 (95% CI, 0.6–2.3) and 3 (95% CI, 2.1–3.8) respectively. There was significant reduction in adhesions between treatment and normal saline treated groups ( p = 0.0292), with no difference between Gelfoam and CD gel groups ( p = 0.56). Average scores on MRI for CD gel, Gelfoam and normal saline groups were 1.4 (95% CI, 0.9–1.8), 1.5 (95% CI, 1.2–1.8) and 1.6 (95% CI, 1.3–1.8) respectively, with no significant difference in fibrosis amongst ( p = 0.2992). Histopathology did not show any adverse effects. Conclusion: CD gel is an effective agent to reduce epidural adhesions with a good safety profile in neural tissue.