Skip to main content
Log in

Use of ADCON®-L to inhibit postoperative peridural fibrosis and related symptoms following lumbar disc surgery: a preliminary report

  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Study design: This was a prospective, randomized, multicenter, double-blind study. Objectives: The study evaluated the use of ADCON®-L Anti-Adhesion Barrier Gel to inhibit peridural fibrosis and reduce fibrosis-related symptoms after first-time lumbar discectomy. Summary of background data: Peridural scarring causes tethering of dura and nerve roots, contributing to pain and functional limitation, and that symptoms are evident by 6 months after surgery. Methods: Following discectomy, ADCON-L was applied to patients in the active treatment group. Outcome measures were reduction of peridural scar and postoperative pain. Results: There is an association between peridural scar and recurrent radicular pain. Patients having extensive peridural scar were three times more likely to experience recurrent radicular pain than those patients with less extensive scarring. ADCON-L inhibited peridural scar. Compared to the control group, there was a 23% reduction in the number of patients with extensive peridural scar and a 120% increase in the number of patients having minimal or no scar. ADCON-L reduced the incidence of activity-related pain. There was up to a 50% reduction in the number of patients reporting increased pain while doing typical activities of daily living. Conclusions: ADCON-L is safe, reduces peridural fibrosis, and improves postoperative patient outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Benoist M, Ficat C, Baraf P, Cauchoix J (1980) Postoperative lumbar epiduroarachnoiditis: diagnostic and therapeutic aspects. Spine 5: 432–436

    Google Scholar 

  2. Boden SC, Wiesel SW (1992) The multiply operated low back patient. In: Rothman RH, Simeone FA (eds) The Spine, 3rd edn. Saunders, Philadelphia, pp 1899–1906

    Google Scholar 

  3. Burton CV, Kirkaldy-Willis WH, Yong-Hing K, Heithoff KB (1981) Causes of failure of surgery on the lumbar spine. Clin Orthop Rel Res 157: 191–199

    Google Scholar 

  4. Cauchoix J, Ficat C, Girard B (1978) Repeat surgery after disc excision. Spine 3: 256–259

    Google Scholar 

  5. Ebeling U, Reichenberg W, Reulen H-J (1986) Results of microsurgical lumbar discectomy: review of 485 patients. Acta Neurochir (Wien) 81: 45–52

    Google Scholar 

  6. Fager CA, Freidberg SR (1980) Analysis of failures and poor results of lumbar spine surgery. Spine 5: 87–94

    Google Scholar 

  7. Finnegan WJ, Fenlin JM, Marvel JP, Nardini RJ, Rothman RH (1979) Results of surgical intervention in the symptomatic multiply-operated back patient. J Bone Joint Surg [Am] 61: 1077–1082

    Google Scholar 

  8. Hoffman RM, Wheeler KJ, Deyo RA (1993) Surgery for herniated lumbar discs: a literature synthesis. J Gen Intern Med 8: 487–496

    Google Scholar 

  9. Hurme M, Katevuo K, Nykvist F, Aalto T, Alaranta H, Einola S (1991) CT five years after myelographic diagnosis of lumbar disk herniation. Acta Radiol 32: 286–389

    Google Scholar 

  10. Jacobs RR, McClain O, Neff J (1980) Control of postlaminectomy scar formation. Spine 5: 223–229

    Google Scholar 

  11. Long DM, McAfee PC (1992) Reoperation on lumbar spine. In: Long DM, McAfee PC (eds) Atlas of Spinal Surgery. Williams & Wilkins, Baltimore, pp 23–57

    Google Scholar 

  12. Long DM, BenDebba M, Torgenson WS (1996) Persistent back pain and sciatica in the United States: patient characteristics (National Low Back Pain Study). J Spinal Dis 9: 40–58

    Google Scholar 

  13. Martin-Ferrer S (1989) Failure of autologous fat grafts to prevent postoperative epidural fibrosis in surgery of the lumbar spine. Neurosurgery 24: 718–721

    Google Scholar 

  14. Merrild U, Sogaard IB (1986) Sciatica caused by perifibrosis of the sciatic nerve. J Bone Joint Surgery 68: 706

    Google Scholar 

  15. North RB, Campbell JN, James CS, et al (1991) Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery 28: 685–690

    Google Scholar 

  16. Pappas CTE, Harrington T, Sonntag VKH (1992) Outcome analysis in 654 surgically treated lumbar disc herniations. Neurosurgery 30: 862–866

    Google Scholar 

  17. Pheasant HC (1975) Sources of failure in laminectomies; symposium on the lumbar spine. Orthop Clin North Am 6: 319–329

    Google Scholar 

  18. Robertson JT (1996) The role of peridural fibrosis in the failed back. Eur Spine J 5 (Suppl 1): S2-S6

    Google Scholar 

  19. Robertson JT, Meric AL, Dohan FC, Schweitzer JB, Wujek JR, Ahmad S (1993) The reduction of postlaminectomy peridural fibrosis in rabbits by a carbohydrate polymer. J Neurosurg 79: 89–95

    Google Scholar 

  20. Ross JS, Delamarter R, Hueftle MG et al (1989) Gadolinium-DTPA-enhanced MR imaging of the postoperative lumbar spine MRI. Am J Neuroradiol 10: 37–46

    Google Scholar 

  21. Ross JS, Robertson JT, Frederickson RCA, Petrie JL, et al (1996) Association between peridural scar and recurrent radicular pain after lumbar discectomy: magnetic resonance evaluation. Neurosurgery 38: 855–861

    Google Scholar 

  22. Scott J, Huskisson EC (1976) Graphic representation of pain. Pain 2: 175–184

    Google Scholar 

  23. Spangfort EV (1972) The lumbar disc herniation: a computer-aided analysis of 2,504 operations. Acta Orthop Scand [Suppl] 142: 5–95

    Google Scholar 

  24. Waddell G, Kummel EG, Lotto WN, Graham JD, Hall H, McCullough JA (1979) Failed lumbar disc surgery and repeat surgery following industrial injuries. J Bone Joint Surg [Am] 61: 201–207

    Google Scholar 

  25. Wiesel SW (1985) The multiply operated lumbar spine. Instr Course Lect 34: 68–77

    Google Scholar 

  26. Weisz GM (1985) The value of CT in diagnosing postoperative lumbar conditions. Spine 11: 164–166

    Google Scholar 

  27. Yong-Hing K, Reilly J, de Korompay V, Kirkaldy-Willis WH (1980) Prevention of nerve root adhesions after laminectomy. Spine 5: 59–64

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This study was supported by a grant from Gliatech Inc.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Petrie, J.L., Ross, J.S. Use of ADCON®-L to inhibit postoperative peridural fibrosis and related symptoms following lumbar disc surgery: a preliminary report. Eur Spine J 5, S10–S17 (1996). https://doi.org/10.1007/BF00298567

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00298567

Key words

Navigation