Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam
Study Design Prospective, randomized study of 100 patients with prolapsed intervertebral disc with an average of 12- to 18-month follow-up postoperatively. Purpose To compare the role of Gelfoam and autologous fat in the prevention of postoperative epidural fibrosis (EF) after lumbar spine surgery....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2022-06-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0268.pdf |
| _version_ | 1811236252379250688 |
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| author | Karan Rajpal Jagdeep Singh Raj Bahadur Kapil Bansal Radhe Shyam Kavin Khatri |
| author_facet | Karan Rajpal Jagdeep Singh Raj Bahadur Kapil Bansal Radhe Shyam Kavin Khatri |
| author_sort | Karan Rajpal |
| collection | DOAJ |
| description | Study Design Prospective, randomized study of 100 patients with prolapsed intervertebral disc with an average of 12- to 18-month follow-up postoperatively. Purpose To compare the role of Gelfoam and autologous fat in the prevention of postoperative epidural fibrosis (EF) after lumbar spine surgery. Overview of Literature EF is a possible sequelae of lumbar disc surgery. Different treatments and surgical strategies have been attempted to prevent postoperative fibrosis without providing consistent long-term results. Methods The study was conducted on 100 adult patients. The patients were randomly allocated into two groups of 50 patients each: group A, autologous fat group, and group B, Gelfoam group. The postoperative follow-up was conducted at intervals of 6 weeks, 3 months, 6 months, and 12 months. Both groups were evaluated clinically (Oswestry Low Back Pain Disability Questionnaire [ODI], Visual Analog Scale [VAS], Straight Leg Raising Test [SLRT]) and radiologically (using Ross grading by contrast magnetic resonance imaging [MRI]) for development of radicular pain and hence EF. Results Based on the analysis, improvement in mean values of ODI score, VAS score, and SLRT were found to be statistically significant postoperatively at intervals of 6 weeks, 3 months, 6 months, and 12 months when compared individually in both groups. However, improvement was greater in the autologous fat group than in the Gelfoam group. Based on contrast-enhanced MRI, the number of patients who developed EF was smaller in the autologous fat group than in the Gelfoam group. Conclusions In the present study, on clinical and radiological assessment, we conclude that both groups prevent radicular pain and postoperative EF individually but relatively autologous fat was found to be more effective than Gelfoam in the prevention of EF and hence radicular pain. |
| first_indexed | 2024-04-12T12:05:53Z |
| format | Article |
| id | doaj.art-7b8ad6de1dc74935be31840f12a4c9e0 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-12T12:05:53Z |
| publishDate | 2022-06-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-7b8ad6de1dc74935be31840f12a4c9e02022-12-22T03:33:42ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462022-06-0116334335110.31616/asj.2020.02681353Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus GelfoamKaran Rajpal0Jagdeep Singh1Raj Bahadur2Kapil Bansal3Radhe Shyam4Kavin Khatri5Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, IndiaDepartment of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, IndiaDepartment of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, IndiaDepartment of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, IndiaDepartment of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, IndiaDepartment of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, IndiaStudy Design Prospective, randomized study of 100 patients with prolapsed intervertebral disc with an average of 12- to 18-month follow-up postoperatively. Purpose To compare the role of Gelfoam and autologous fat in the prevention of postoperative epidural fibrosis (EF) after lumbar spine surgery. Overview of Literature EF is a possible sequelae of lumbar disc surgery. Different treatments and surgical strategies have been attempted to prevent postoperative fibrosis without providing consistent long-term results. Methods The study was conducted on 100 adult patients. The patients were randomly allocated into two groups of 50 patients each: group A, autologous fat group, and group B, Gelfoam group. The postoperative follow-up was conducted at intervals of 6 weeks, 3 months, 6 months, and 12 months. Both groups were evaluated clinically (Oswestry Low Back Pain Disability Questionnaire [ODI], Visual Analog Scale [VAS], Straight Leg Raising Test [SLRT]) and radiologically (using Ross grading by contrast magnetic resonance imaging [MRI]) for development of radicular pain and hence EF. Results Based on the analysis, improvement in mean values of ODI score, VAS score, and SLRT were found to be statistically significant postoperatively at intervals of 6 weeks, 3 months, 6 months, and 12 months when compared individually in both groups. However, improvement was greater in the autologous fat group than in the Gelfoam group. Based on contrast-enhanced MRI, the number of patients who developed EF was smaller in the autologous fat group than in the Gelfoam group. Conclusions In the present study, on clinical and radiological assessment, we conclude that both groups prevent radicular pain and postoperative EF individually but relatively autologous fat was found to be more effective than Gelfoam in the prevention of EF and hence radicular pain.http://www.asianspinejournal.org/upload/pdf/asj-2020-0268.pdfautologous fatepidural fibrosisfailed back surgery syndromegelfoamradiculopathy |
| spellingShingle | Karan Rajpal Jagdeep Singh Raj Bahadur Kapil Bansal Radhe Shyam Kavin Khatri Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam Asian Spine Journal autologous fat epidural fibrosis failed back surgery syndrome gelfoam radiculopathy |
| title | Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam |
| title_full | Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam |
| title_fullStr | Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam |
| title_full_unstemmed | Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam |
| title_short | Postoperative Epidural Fibrosis Prevention: Which Is Better–Autologous Fat versus Gelfoam |
| title_sort | postoperative epidural fibrosis prevention which is better autologous fat versus gelfoam |
| topic | autologous fat epidural fibrosis failed back surgery syndrome gelfoam radiculopathy |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0268.pdf |
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