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Spinal Cerrahi Sonrası Epidural Fibrozisin Önlenmesinde Omentum Greftinin Etkinliği: Deneysel Çalışma

The Effectiveness of Omental Greft in Preventing Epidural Fibrosis after the Spinal Surgery: An Experimental Study

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Abstract (2. Language): 
Several biological and nonbiological materials have been used to prevent epidural fibrosis which has been considered as the most important factor affecting occurence of persistent low back pain after lumbar spinal surgery. The effect of homolog pediculated or free omentum grafts on epidural fibrosis after lumbar laminotomy and annular fenestration was investigated in Sprague Dawley rats (weighing 400 to 450 grams). In the control group (Group I) (n=10); laminotomy + annular fenestration, in the experimental group (group Il) (n=10); laminotomy + annular fenestration + homolog pediculated omental greft, and in group IIl (n=10) laminotomy + annular fenestration + free omental grefting were performed. All rats were sacrificed four weeks later and examined histopathologicaly. The epidural fibrosis reduced significantly in the treatment groups compared to the control group (p< 0.001). But there was no significant difference between free omentum and pedinculated omentum groups. Consequently, pediculated and free omental greft administration decreases the postsurgical epidural fibrosis experimentally.
Abstract (Original Language): 
Lomber spinal cerrahi sonrası geçmeyen bel ağrısının en önemli etkeni olarak görülen epidural fibrozisin önlenebilmesi amacı ile birçok biyolojik ve biyolojik olmayan materyaller denenmiştir. Biyolojik bir materyal olan omentumun, pediküllü ve serbest kullanımının epidural fibrozis üzerine olan etkinliği sıçanlarda (Sprague Dawley, 400-450g) laminatomi + annular fenestrasyon modelinde araştırıldı. Kontrol grubunda (Grup I) (n=10); laminatomi + annular fenestrasyon, deney gruplarında ise Grup II (n=10); laminatomi + annular fenestrasyon + pediküllü omentum greft, ve Grup III (n=10); laminatomi + annular fenestrasyon + serbest omentum grefti uygulandı. Dört hafta sonra sakrifiye edilen ratlar histopatolojik olarak incelendi. Kontrol grubu ile karşılaştırıldığında, deney gruplarının (pediküllü ve serbest omental greft) epidural fibrozisi istatistiksel olarak anlamlı derecede azalttığı görüldü (p<0,001). Ancak pediküllü ve serbest omental greft grupları arasında bir fark saptanmadı. Sonuç, pediküllü ve serbest omental greftler, deneysel olarak spinal cerrahi sonrası epidural fibrozis oluşumunu anlamlı derecede azaltmaktadır.
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