Collagen matrix duraplasty for cranial and spinal surgery: a clinical and imaging study
- 1 January 2007
- journal article
- research article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 106 (1), 45-51
- https://doi.org/10.3171/jns.2007.106.1.45
Abstract
The repair of dural defects is controversial in contemporary neurosurgery. To date, collagen-based products remain a continued area of interest in the development of dural grafts. The authors conducted a prospective case-control study in which they evaluated collagen matrix in the repair of dural defects following cranial and spinal surgery by using specific clinical and magnetic resonance (MR) imaging outcome measures. Enrolled in the study were 79 patients, 36 male (45.6%) and 43 female (54.4%), with a mean age of 53 +/- 15.8 years. The pathological diagnosis was brain tumor in 49 cases (62%), vascular conditions in 16 (20.2%), degenerative spine in 10 (12.7%), trauma in two (2.5%), and other in two (2.5%). Most of the patients underwent supratentorial craniotomy (57; 72.2%), whereas 11 patients (13.9%) each underwent posterior fossa and spinal surgery. Sixty-three patients (79.7%) completed the study, which included clinical and MR imaging evaluations at 3 months postsurgery. There were no cerebrospinal fluid (CSF) leaks or delayed hemorrhages. The neurosurgical wound infection rate was 3.8%: superficial wound infection in two cases and deep infection and brain abscess in one case (recurrent brain tumor following radiation therapy). Among the 63 patients in whom 3-month postsurgery imaging data were available, asymptomatic small pseudomeningoceles were detected on MR imaging in two (3.2%); a minor subgaleal fluid collection, which resolved spontaneously, was apparent in another patient (1.6%). Nonspecific dural enhancement was demonstrated on images obtained in seven patients (11.1%), and asymptomatic spinal epidural enhancement was observed on images obtained in two of three patients who had undergone lumbar laminectomy for spinal stenosis. When used as a dural onlay graft, collagen matrix had a 100% CSF containment rate but might be associated with occult radiological abnormalities.Keywords
This publication has 44 references indexed in Scilit:
- Collagen Matrix (DuraGen) in Dural Repair: Analysis of a New Modified TechniqueSpine, 2004
- Letter to the editorHead & Neck, 2001
- Relationships between epidural fibrosis, pain, disability, and psychological factors after lumbar disc surgeryEuropean Spine Journal, 2000
- Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRIEuropean Spine Journal, 1999
- Bovine Pericardium for Dural Grafts: Clinical Results in 35 PatientsNeurosurgery, 1996
- Posterior Fossa ReconstructionNeurosurgery, 1994
- Dura Mater Substitutes in the Surgical Treatment of MeningiomasJournal of Neuroscience Nursing, 1994
- Xenogeneic pericardium as a dural substitute in reconstruction of suboccipital dura mater in childrenJournal of Neurosurgery, 1989
- Spinal Cord Compression: A Complication of Silicone-Coated Dacron Dural Grafts. Report of Two CasesNeurosurgery, 1989
- Infections in neurosurgery: A retrospective study of 1143 patients and 1517 operationsActa Neurochirurgica, 1985