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. 2017 Aug 1:8:169.
doi: 10.4103/sni.sni_142_17. eCollection 2017.

Epidural scarring after lumbar disc surgery: Equivalent scarring with/without free autologous fat grafts

M Dobran  1 , D Brancorsini  2 , M Della Costanza  1 , V Liverotti  1 , F Mancini  1 , D Nasi  1 , M Iacoangeli  1 , M Scerrati  1
Affiliations

Epidural scarring after lumbar disc surgery: Equivalent scarring with/without free autologous fat grafts

M Dobran et al. Surg Neurol Int. .

Abstract

Background: To limit epidural fibrosis and prevent scar formation/nerve tethering that may contribute to chronic postoperative pain; some surgeons have utilized epidural autologous fat grafts following lumbar microdiscectomy.

Methods: We investigated the correlation between post-microdiscectomy epidural scarring [including select magnetic resonance imaging (MRI) studies] and clinical outcomes in 36 patients operated for symptomatic. MRI documented L4-L5 and L5-S1 disk herniations with (18 patients) and without (18 patient) the application of free fat grafts. In addition, histological evaluation of the original fat grafts was performed in 4 patients requiring additional surgery.

Results: We found no clear association between the use of autologous graft fats and the clinical outcomes in this study.

Conclusion: In this preliminary study involving only 36 patients, the prospective randomized use of free autologous fat grafts did not appear to influence outcomes following microdiscectomy.

Keywords: Epidural fibrosis; failed back syndrome; microdiscectomy; post-discectomy syndrome.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
H and E specimens of autologous graft-fat. (a-c) Normal adipocytes with no fibroblasts invasion. (d) The arrow shows fibroblast invasion of the autologous free fat -graft
Figure 2
Figure 2
Axial MRI T2W images at the level of surgical access. (a-c) Patients operated without autologous graft-fat with evidence of scar tissue formation (red line). (d) Patient operated without autologous graft-fat without sign of scar tissue. (e-g) Patients operated with positioning of autologous fat-graft (blue line) and evidence of scar formation (red line) (h) Patient operated with positioning of autologous fat-graft (blue line), without sign of scar tissue formation
See this image and copyright information in PMC

References

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