Comparison of the acute effects of hemostatic agents on neural tissues in spine surgery: Histologic analysis in rat models

Abstract

Gokhan Meric, Omer Akcali, Serap Cilaker Micili, Alper Bagriyanik

Objective: The most frightening and likely complication of chemical hemostatic agents is neurologic deficit. The histological basis of this potential complication is still unknown. The aim of this study is to observe the acute histologic effects of routinely used hemostatic agents on neural tissues in a rat model. Methods: Eighteen Winstar Albino rats were operated and same-level laminectomies were performed. The rats were divided into three groups. In group 1 (control group), surgical layers were sutured in routine manner after laminectomy. In group 2 (gelatin sponge group), dura mater was covered with gelatin sponge after laminectomy, while oxidized cellulose was used for coverage in group 3 (oxidized cellulose group). Neurologic evaluations were made for all test subjects. Fortyeight hours after the operation, rats were sacrificed and lumber spines were excised with all surrounding tissues for evaluation by light microscopy of the acute effects of agents on neural tissues. Neurologic scores and histologic findings were compared with double-blind evaluation. Results: There were no statistically significant differences between the three groups in the histologic findings and clinical evaluations. However, the inflammatory reaction was more severe in the oxidized cellulose group. Conclusion: Both gelatin sponge and oxidized cellulose did not increase the cellular necrosis of neural tissues. However, oxidized cellulose may lead to an increased local inflammatory reaction