E-ISSN: 1019-5157
ISSN: 2651-5024
Research
A Biodegradable Polyhydroxybutyrate/Alginate Fibrillar Membrane Attenuates Post-Laminectomy Epidural Fibrosis in Rats
HIDIR OZER✉ ,
Hatice HANCI ,
Yeliz KASKO ARICI ,
murat demirbilek ,
Azra Özer ,
Vugar Nabi ,
Ömer Faruk Şahin ,
Ali Yılmaz ,
Yurdal Serarslan ,
Orhan Baş
Department of Neurosurgery, Ordu University, Faculty of Medicine; Department of Histology and Embryology, Ordu University, Faculty of Medicine,; Biostatistics and Medical Informatics, Ordu University, Faculty of Medicine; Biology, Ankara Hacı Bayram Veli University; Tıp (İngilizce), Ufuk University; Department of Orthopaedics and Traumatology, Ministry Of Health ,University of Health Science,Antalya Research and Education Hospital.; Neurosurgery, Ordu University, Faculty of Medicine; Neurosurgery, Ordu University Medical Faculty; Anatomy, Ordu University, Faculty of Medicine
Accepted: 12/09/2026
Article in Press
Corresponding Author:
HIDIR OZER (hidirozer@hotmail.com)
Abstract
Aim
Epidural scar formation after laminectomy is a key pathobiological contributor to failed back surgery syndrome, and the development of a biodegradable, mechanically stable, and biologically inert epidural barrier remains an unmet need in spine surgery. This experimental study investigated the anti-fibrotic efficacy of a novel fibrillar polyhydroxybutyrate-alginate membrane against laminectomy-induced epidural fibrosis in rats.
Material and Methods
A total of 24 adult male Wistar-Hannover rats were assigned at random to three groups of equal size: a control group undergoing laminectomy alone, a PHB group receiving epidural implantation of a polyhydroxybutyrate membrane after laminectomy, and a PHBA group receiving an alginate-coated polyhydroxybutyrate membrane in the epidural space following laminectomy. A standardized L3 laminectomy was performed in all animals, with euthanasia conducted 4 weeks after the procedure.
Results
All animals completed the 4-week follow-up. Histopathological epidural fibrosis grading showed a stepwise reduction from the control group to the PHB and PHBA groups. Median fibrosis grades were 3.0 [2.5–3.0] in the control group, 2.0 [1.5–2.0] in the PHB group, and 1.0 [1.0–1.5] in the PHBA group. The overall between-group difference was significant (Kruskal–Wallis H=15.26, p<0.001). Pairwise post hoc comparisons showed that fibrosis grades were significantly higher in the control group than in both the PHB group (p=0.038) and the PHBA group (p<0.001). Fibrosis grades were numerically lower in the PHBA group than in the PHB group by comparison; however, the between-group difference was not statistically significant after correction (p=0.522). Severe fibrosis occurred in 75.0% of control animals, whereas no severe fibrosis was observed in either barrier-treated group. In the PHBA group, 75.0% of animals demonstrated only mild fibrosis.
Conclusion
In this rat laminectomy model, PHB and PHBA membranes were associated with lower epidural fibrosis grades, with no severe fibrosis observed. PHBA was numerically favorable but not superior to PHB; findings remain preliminary proof-of-concept evidence.
Epidural scar formation after laminectomy is a key pathobiological contributor to failed back surgery syndrome, and the development of a biodegradable, mechanically stable, and biologically inert epidural barrier remains an unmet need in spine surgery. This experimental study investigated the anti-fibrotic efficacy of a novel fibrillar polyhydroxybutyrate-alginate membrane against laminectomy-induced epidural fibrosis in rats.
Material and Methods
A total of 24 adult male Wistar-Hannover rats were assigned at random to three groups of equal size: a control group undergoing laminectomy alone, a PHB group receiving epidural implantation of a polyhydroxybutyrate membrane after laminectomy, and a PHBA group receiving an alginate-coated polyhydroxybutyrate membrane in the epidural space following laminectomy. A standardized L3 laminectomy was performed in all animals, with euthanasia conducted 4 weeks after the procedure.
Results
All animals completed the 4-week follow-up. Histopathological epidural fibrosis grading showed a stepwise reduction from the control group to the PHB and PHBA groups. Median fibrosis grades were 3.0 [2.5–3.0] in the control group, 2.0 [1.5–2.0] in the PHB group, and 1.0 [1.0–1.5] in the PHBA group. The overall between-group difference was significant (Kruskal–Wallis H=15.26, p<0.001). Pairwise post hoc comparisons showed that fibrosis grades were significantly higher in the control group than in both the PHB group (p=0.038) and the PHBA group (p<0.001). Fibrosis grades were numerically lower in the PHBA group than in the PHB group by comparison; however, the between-group difference was not statistically significant after correction (p=0.522). Severe fibrosis occurred in 75.0% of control animals, whereas no severe fibrosis was observed in either barrier-treated group. In the PHBA group, 75.0% of animals demonstrated only mild fibrosis.
Conclusion
In this rat laminectomy model, PHB and PHBA membranes were associated with lower epidural fibrosis grades, with no severe fibrosis observed. PHBA was numerically favorable but not superior to PHB; findings remain preliminary proof-of-concept evidence.
Keywords
Epidural fibrosis
Laminectomy
Polyhydroxybutyrate
Alginate
Biomaterials
Failed back surgery syndrome.