Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery

Kazutoshi Hida; Satoshi Yamaguchi; Toshitaka Seki; Shunsuke Yano; Minoru Akino; Shunsuke Terasaka; Takanori Uchida; Yoshinobu Iwasaki

doi:10.1016/j.surneu.2005.07.059

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Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery

Journal article

Peer reviewed

Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery

Kazutoshi Hida, Satoshi Yamaguchi, Toshitaka Seki, Shunsuke Yano, Minoru Akino, Shunsuke Terasaka, Takanori Uchida and Yoshinobu Iwasaki

Surgical neurology, Vol.65(2), pp.136-142

2006

DOI: 10.1016/j.surneu.2005.07.059

PMID: 16427404

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Abstract

In spinal surgery, repair of the dura is difficult when it is torn or fragile or is ossified as in cases with ossification of posterior longitudinal ligament. We report our experience with a nonsuture dural repair technique in patients undergoing spinal surgery; it uses a dura substitute composed of polyglycolic acid (PGA) mesh and fibrin glue. Here, we report the efficacy and safety of nonsuture duroplasty using PGA mesh and fibrin glue (PGA-fibrin sheet). The artificial dura mater is composed of a PGA-fibrin sheet. The dural defect is covered with a patch sprayed with fibrin glue without suturing to the dura mater. We first evaluated this technique in an experimental study by performing water leakage tests. Between May 2001 and January 2005, we used it in 160 spinal surgeries that required intraoperative dura repair. Our preliminary tests showed that the threshold for water pressure without leakage was 161 ± 42 and 96.5 ± 32 mm Hg when the unsprayed margin around the perimeter of the patch was 5 and 2 mm, respectively. Of the 160 operated patients, 10 (6.3%) experienced subcutaneous cerebrospinal fluid (CSF) leakage. Of these, 6 required a second operation; in the other 4, the CSF collection diminished spontaneously. There were no other complications such as allergic reaction, adhesion, or infection. In combination with CSF diversion, the PGA-fibrin sheet is a viable alternative method for dural repair in spinal surgery.

Polyglycolic acid

Duroplasty

Dura substitute

Fibrin glue

CSF leakage

Details

Title: Subtitle: Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery
Creators: Kazutoshi Hida - Department of Neurosurgery, University of Hokkaido, Graduate School of Medicine, Sapporo 060-8638, Japan
Satoshi Yamaguchi - Department of Neurosurgery, University of Hokkaido, Graduate School of Medicine, Sapporo 060-8638, Japan
Toshitaka Seki - Department of Neurosurgery, University of Hokkaido, Graduate School of Medicine, Sapporo 060-8638, Japan
Shunsuke Yano - Department of Neurosurgery, University of Hokkaido, Graduate School of Medicine, Sapporo 060-8638, Japan
Minoru Akino - Sapporo Azabu Neurosurgical Hospital, Sapporo 007-0840, Japan
Shunsuke Terasaka - Department of Neurosurgery, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
Takanori Uchida - The Chemo-Sero-Therapeutic Research Institute, Kumamoto 860-8568, Japan
Yoshinobu Iwasaki - Department of Neurosurgery, University of Hokkaido, Graduate School of Medicine, Sapporo 060-8638, Japan
Resource Type: Journal article
Publication Details: Surgical neurology, Vol.65(2), pp.136-142
DOI: 10.1016/j.surneu.2005.07.059
PMID: 16427404
NLM abbreviation: Surg Neurol
ISSN: 0090-3019
eISSN: 1879-3339
Publisher: Elsevier Inc
Language: English
Date published: 2006
Academic Unit: Neurosurgery
Record Identifier: 9984040234302771

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