Influence of TachoComb® in Comparison to Local Hemostyptic Agents on Epidural Fibrosis in a Rat Laminectomy Model

Abstract

This animal experimental study was designed to examine the effects of TachoComb®, a fixed combination of collagen with tissue adhesive, as an interposition membrane on the development of spinal epidural fibrosis in comparison to other hemostyptic materials. In 10 Wistar rats, four laminectomies were performed at lumbar and sacral vertebrae. Alternately, a piece of TachoComb®, Spongostan®, or Tabotamp® was placed into each laminectomy site. One laminectomy site served as an empty control (n = 10). 8 weeks later, the animals were sacrificed, and the spinal column including surrounding muscle tissue was removed en bloc from each rat and fixed in formaldehyde. After decalcification and staining the specimens were graded by a neuropathologist in a blindfold test for severity of epidural fibrosis as “light-moderate” or “marked”. Epidural scarring of variable density was seen in all laminectomy sites. Light epidural fibrosis, without any adhesion to dura, as only noted in cases after application of TachoComb® (n = 4/10) and Spongostan® (n = 1/10). All other slices showed marked epidural fibrosis with dura adherence regardless of the implanted material. Statistical analysis revealed significantly lower epidural fibrosis after application of TachoComb® compared to all other groups (p < 0.05). In this series, TachoComb® is more effective in reducing the epidural fibrosis than Spongostan®, and Tabotamp®. However, complete prevention of scar tissue formation was not achieved.

Key words

Epidural fibrosis - failed back surgery syndrome - interposition membrane - hemostyptica

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