June 25Implantation of amniotic membrane to reduce postlaminectomy

Articles, Back & Spine

Approximately 185,000 lumbar spine surgeries are performed every year in the US to treat various clinical conditions such as spondylolisthesis, spinal stenosis, and disco genic back pain. Failed back surgery syndrome
(FBSS) is characterized by the presence of intractable pain and varying degrees of functional incapacity after lumbar spine surgery.

It occurs in 13–61% of patients who undergo back surgery. The reasons for FBSS include inadequate surgical decompression, recurrent disc herniation, lumbar instability, extensive epidural scar, and inadequate fusion. The postoperative epidural scar can cause extradural compression or dural tethering, which results in recurrent radicular pain and physical impairment.

One particularly promising material is amniotic membrane (AM), which is the inner layer of fetal membrane.
This translucent membrane is composed of an inner layer of epithelial cells planted on a basement membrane. AM can reduce inflammation, inhibit vascularization, combat infection, and limit postoperative adhesion.

It has been used to treat variable diseases such as non-healing skin ulcers, vaginal atresia, and severe ocular surface disease. Moreover, it can serve as adjunctive tissue to reduce surgical adhesions in abdominal surgery and otolaryngologic surgery. Furthermore, AM is an immune privileged tissue and rarely causes immunologic rejection.

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