Turkish Neurosurgery
To What Extent Topical Application of Cova™ and Tisseel® Cause Spinal Peridural Fibrosis? Comparison with Adcon® Gel: An Experimental Study in Rat Model.
Atilla Kazanci1, Oktay Gurcan1, Ahmet Gurhan Gurcay1, Evrim Onder2, Burak Kazanci3, Mesut Emre Yaman4, Murad Bavbek1
1Ankara Atatürk Research and Education Hospital, Neurosurgery, Ankara,
2Diskapi Yildirim Beyazit Training and Research Hospital, Pathology, Ankara,
3Ufuk University Medical School Hospital, Neurosurgery, Ankara,
4Memorial Hospital , Neurosurgery, Ankara,
DOI: 10.5137/1019-5149.JTN.16809-15.1

Aim:Leptomeningeal adhesions and fibrosis in spinal peridural space are the most common causes of post-laminectomy syndrome. Fibrin sealant agents and membrane barriers are commonly used for hemostasis and sealing purposes in spinal surgery. Peridural fibrosis may be a risk of usage of these topical agents. In our study we aimed to compare the effects of Cova™, Tisseel® and Adcon® Gel on spinal epidural fibrosis in an experimental rat model.Material and Methods:32 Sprague Dawley female rats were divided into 4 groups randomly. Groups were constituted as group 1; Cova™ group (laminectomy + Cova), group 2; Tisseel® group (laminectomy + Tisseel), group 3 Adcon®Gel group (laminectomy + Adcon®Gel), group 4; control group (laminectomy only). Six weeks after laminectomy spinal columns were removed en block between L1 and L4 vertebrea. Epidural fibrosis was evaluated histologically and the results were compared statistically. Results:In groups 1, 2 and 3 statistically significant reduction of epidural fibrosis was achieved when compared with the control group (p<0.05). Our data revealed a statistically significant difference between group 1 and group 3(p<0.05). When we compare group 2 and 3 the fibrosis grades were not different between these two groups (p>0.05). Conclusion:Our study demonstrated that fibrin sealant agent Tisseel® and membrane barrier Cova™ do not enhance epidural fibrosis following laminectomy in experimental rat model. We suggested that Cova™ and Tisseel® may be appropriate for use during spinal surgery for hemostasis and leakage prevention purposes and it is safe to leave these materials on the operation surface.

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