Comparison of the effect of haemostatic neural tissues in spine surgery (Histological analysis in rat models)

Epidural bleeding and hematoma is very important in spinal surgical procedures. The bleeding should be controlled to permit spinal operations. Some methods of hemostasis such as pressure to the bleeding area, ligation or electrocauterization generally are not feasible. For this reason, various chemical hemostatic agents (absorbabl gelatin sponge, oxydized cellulose) are used to stop bleeding. The most frightened and possible complication of chemical hemostatic agents is postsurgical neurolgic deficits. This problem sometimes can be seen during clinical practice, however, detailed histological studies with good evidence is seldom. The aim of our study is comparison of the effect of hemostatic agents on neural tissues both histologically and clinically.In this study, 18 winstar albino rats were operated and two level laminectomies were performed. The rats were divided into three groups. In group 1 (control group), muscle, subdermis and dermis were sutured in routine manner. In group 2 (gelatin sponge group), duramater was covered with gelatin sponge after laminectomy, while oxidized cellulose was used in group 3 (oxidized cellulose group). .Neurologic evaluations were made for all test subjects. 48 hours after operation, rats were sacrified and lumber spines were exicised with all surrounding tissues for evaluation of the effect of agents on neural tissues by light microscopy. Neurologic scores and histologic findings were compared with double-blind evaluation.As a result; there were no statistically singnificant differences of histologic findings, early and late neurologic evaluation between the groups. However, inflammatory reaction was more severe in oxidized cellulose group. Oxidized cellulose is increased the acidity of tissues for hemostatic effects, and thus may lead to clear inflammatory reaction.Keywords; Oxidized cellulose, absorbable gelatin sponge, rat model.