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

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Title: Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery
Authors: Hida, Kazutoshi1 Browse this author →KAKEN DB
Yamaguchi, Satoshi Browse this author
Seki, Toshitaka Browse this author
Yano, Shunsuke Browse this author
Akino, Minoru Browse this author
Terasaka, Shunsuke Browse this author →KAKEN DB
Uchida, Takanori Browse this author
Iwasaki, Yoshinobu Browse this author
Authors(alt): 飛騨, 一利1
Keywords: dura substitute
CSF leakage
fibrin glue
polyglycolic acid
Issue Date: Feb-2006
Publisher: Elsevier Inc
Journal Title: Surgical Neurology
Volume: 65
Issue: 2
Start Page: 136
End Page: 142
Publisher DOI: 10.1016/j.surneu.2005.07.059
Abstract: 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.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 飛騨 一利

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