Objective: To investigate the clinical effect of polylactic acid membrane in prevention of epidural scar and adhesion.
Methods: From July 1998 to April 2000, 62 patients with lumbar disc herniation were randomly assigned into two groups. All were treated surgically with discectomy by fenestration or laminectomy. One group were placed with a thin of polylactic acid membrane covering the interlaminar space(n = 32). The thickness of the film was 0.1 mm. The other group was blank control(n = 30). After 2 weeks of operation, we observed the local and systemic reactions. After 6 months clinical symptoms were revaluated and the degrees of epidural scar and adhesion were determined by CT scans.
Results: After 2 weeks, we found no adverse systemic reactions in all patients. Wound healing was excellent. No abnormalities of hepatic and renal functions as well as blood for routine were found. Temperature after operation was normal. After 6 months, the curative effects were as follows in experimental group and in control group: excellent in 27 patients and in 24 patients, good in 4 patients and in 4 patients, fair in 1 patient and in 1 patient, and poor in 0 patient and in 1 patient, respectively. There are no significant difference between two groups. The CT scans showed no adhesion between the epidural scar and the dural sac in all patients of experimental group. There existed various extents of adhesion in control group.
Conclusion: The results demonstrate that the polylactic acid membrane can effectively prevent the epidural scar adhesion with a good biocompatibility and no toxity. Its clinical application was promising.