Use of a collagen biomatrix (TissuDura®) for dura repair: a long-term neuroradiological and neuropathological evaluation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ciro Parlato , Giuseppe di Nuzzo , Marianna Luongo , Raffaele Stefano Parlato , Marina Accardo , Luigi Cuccurullo , Aldo Moraci
- چاپ و سال / کشور: 2011
Description
Purpose The aim of this study was to evaluate the clinical, neuroradiological, and neuropathological outcomes of patients treated with equine collagen foil (TissuDura®) as a dura mater substitute during cranial and spinal neurosurgical procedures. Materials and Methods All patients treated at the Department of Neurosurgery of the Second University of Naples with TissuDura between 2005 and 2009 were included. Dural reconstruction was performed using TissuDura, overlaid 1 cm over the dural defect with additional fixation using fibrin glue. No surgical sutures were used. Patients underwent postoperative contrast-enhanced magnetic resonance scans at 1 week, 1 month, and 1 year after surgery to detect any cerebrospinal fluid (CSF) leaks, infections, inflammations, or CSF circulation in the surgical region. Results Dural reconstruction was performed in 74 patients, including 50 patients with tumors, two with C2 neurinoma, two with acoustic neurinoma, six with Chiari I malformation, two with severe head injury, and 12 requiring spinal surgery. Clinical and neuroradiological findings were normal and no signs of graft rejection or CSF leaks at postoperative follow-up were observed. In two cases of atypical meningioma, re-operation of the dural reconstruction was performed after 1 year. No adherences between brain and neodura were detected, and histopathological investigations demonstrated dural regeneration. Conclusions Following dural reconstructions with TissuDura without surgical sutures, no local toxicity or complications were observed for up to 1 year. TissuDura demonstrated elasticity, non-reactivity, and good adaptability. The overlay technique using fibrin glue was simple and fast. Future studies and longer follow-up are needed to confirm the efficacy of TissuDura.
Acta Neurochir (2011) 153:142–147 DOI 10.1007/s00701-010-0718-2 Received: 24 February 2010 / Accepted: 11 June 2010 / Published online: 12 July 2010 # Springer-Verlag 2010
