Prevention of epidural fibrosis in a prospective series of 100 primary lumbo-sacral discectomy patients: Follow-up and assessment at re-operation

An implantable device (ADCON(R)-L), which acts as a resorbable barrier to e pidural fibrosis following lumbar discectomy, has been shown to minimize th e formation of peridural fibrotic scar and to improve the post-operative ou tcome, in two large controlled and multi-center clinical trials. In this pr ospective study, 100 patients were treated with the device during their fir st-time lumbo-sacral discectomy surgeries and monitored for 12 months. Duri ng this time interval, four of these patients required re-operation. In the se cases, epidural scar and ease of dissection were systematically evaluate d and recorded. At the time of reoperation, in all four patients, absent or minimal soft scar tissue was found where ADCON(R)-L had been placed, no ad hesions to the involved root were observed and the dissection was easier th an expected; the healing of the surgical wound was excellent, and no residu al implant material was found. These observations indicate that the use of ADCON(R)-L at the time of the first lumbar disc surgery minimizes the hazar ds and difficulty that can be encountered in a subsequent revision surgery due to the presence of epidural fibrosis, and may therefore improve the cha nces of satisfactory outcome following re-operation.