The role of chitosan membranes on scarring process following lumbar surgery :post-laminectomy experimental model

Abstract

Introduction: Post-operative scarring process on lumbar surgery is object of several studies mainly because of the epidural fibrosis formation. Chitosan have shown promising effect fibrosis prevention. The aim of this study is to determine the influence chitosan-silane membrane on the lumbar surgery scarring process. These membranes have improved mechanical strength which makes it suitable to mantain a predefined shape. Materials/methods: Fourteen New Zealand male rabbits underwent two level lumbar laminectomy. Laminectomy sites were randomly selected for biomaterial or control. Chitosan membranes were prepared and care was taken in order to make it adapted to the bone defect dimensions in a way that it covered the totality of the defect and also the bone margins. Histological analysis was performed by haematoxylin/eosin and by Masson’s trichrome staining four weeks after laminectomy. Results: Microscope observations revealed the presence of a wellorganized regenerating tissue, integrated in the surrounding vertebral bone tissue with a regular and all-site interface on the chitosan sites, in clear contrast with the presence of a disorganized regenerating tissue with aspects consistent with the persistence of a chronic inflammatory condition, on control sites. Conclusions: The results of this study clearly demonstrated that chitosan had an organizing effect on post-operative scarring process. The presence of the chitosan membrane resulted on a well-organized tissue integrated in the surrounding vertebral bone tissue with signs of regenerative bone tissue in continuity with native bone. This can be a major feature on the dynamics of epidural fibrosis formation