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

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タイトル: Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery
著者: Hida, Kazutoshi 著作を一覧する
Yamaguchi, Satoshi 著作を一覧する
Seki, Toshitaka 著作を一覧する
Yano, Shunsuke 著作を一覧する
Akino, Minoru 著作を一覧する
Terasaka, Shunsuke 著作を一覧する
Uchida, Takanori 著作を一覧する
Iwasaki, Yoshinobu 著作を一覧する
キーワード: dura substitute
CSF leakage
fibrin glue
polyglycolic acid
duroplasty
発行日: 2006年 2月
出版者: Elsevier Inc
誌名: Surgical Neurology
巻: 65
号: 2
開始ページ: 136
終了ページ: 142
出版社 DOI: 10.1016/j.surneu.2005.07.059
抄録: Background: In spinal surgery, repair of the dura is difficult when it is torn, fragile, or is ossified as in cases with OPLL. We report our experience with a non-suture dural repair technique in patients undergoing spinal surgery; it employs a dura substitute composed of polyglycolic acid (PGA) mesh and fibrin glue. Here we report the efficacy and safety of non-suture duroplasty using PGA mesh and fibrin glue (PGA-fibrin sheet). Methods: 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. Results: Our preliminary tests showed that the threshold for water pressure without leakage was 161 ± 42 mmHg and 96.5 ± 32 mmHg when the unsprayed margin around the perimeter of the patch was 5 mm and 2 mm, respectively. Of the 160 operated patients, 10 (6.3%) experienced subcutaneous 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. Conclusion: In combination with CSF diversion, the PGA-fibrin sheet is a viable alternative method for dural repair in spinal surgery.
Relation (URI): http://www.sciencedirect.com/science/journal/00903019
資料タイプ: article (author version)
URI: http://hdl.handle.net/2115/5920
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 飛騨 一利

 

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