Abstract
Dural grafts are sometimes necessary for repairing spinal dural defects. The search for an ideal material for duraplasty remains a controversial topic. Twenty-six adult male Wistar-Albino rats, weighing 260-380 g, were used. The rats were divided into three groups: Control (n=10), Fascia (n=6), and Gore-Tex (polytetrafluoroethylene) Surgical Membrane group (n=10). After laminectomy was performed on the rats, a dural defect was created. Then, one of the procedures 'leaving the defect open,' 'duraplasty with fascia,' and 'duraplasty with Gore-Tex surgical membrane' was performed. On the 60th day after surgery, the rats were euthanized, and histological investigations were conducted to examine the granulation tissue and adhesions in the operative area. It was observed that granulation tissue filled the defect area in all three groups. In the fascia group, it was observed that the fascia formed a barrier between the dura mater and neural tissue and the granulation tissue, but it was filled with dense granulation tissue and there was adhesion. It was found that the granulation tissue did not adhere to the Gore-Tex surgical membrane in the Gore-Tex surgical membrane group, and the Gore-Tex surgical membrane created an excellent physical barrier preventing adhesion between the dura mater and neural and the granulation tissues.
Keywords
Ethical Statement
Ethical Approval: Ege University Animal Experiments Local Ethics Committee received the necessary approval for the study. (Dated 12.03.2002 and numbered 2002.08)
Thanks
Acknowledgements: We would like to thank Dear Dr Mine Tunakan, who made great contributions to the preparation of this study. Declaration: This study was presented in the 'Presentations of the Year' session at the 19th Scientific Congress of the Association of Nervous System Surgery, held in Antalya, Turkey, on 19-22 October 2023, and received the 'Second Place' award.
References
- 1. Park YK, Tator CH. Prevention of arachnoiditis and postoperative tethering of the spinal cord with Gore-Tex surgical membrane: an experimental study with rats. Neurosurgery. 1998;42(4):813-23; discussion 23-4.
- 2. Thammavaram KV, Benzel EC, Kesterson L. Fascia lata graft as a dural substitute in neurosurgery. South Med J. 1990;83(6):634-6.
- 3. Keller JT, Ongkiko CM Jr, Saunders MC, et al. Repair of spinal dural defects. An experimental study. J Neurosurg. 1984;60(5):1022-8.
- 4. Kurt G, Cemil B, Celik B, et al. Comparison of Oxiplex and Gore-Tex effectivity in an experimental peridural fibrosis model. Neurocirugia (Astur). 2009;20(4):360-6.
- 5. Vakis A, Koutentakis D, Karabetsos D, et al. Use of polytetrafluoroethylene dural substitute as adhesion preventive material during craniectomies. Clin Neurol Neurosurg. 2006;108(8):798-802.
- 6. Attenello FJ, McGirt MJ, Garcés-Ambrossi GL, et al. Suboccipital decompression for Chiari I malformation: outcome comparison of duraplasty with expanded polytetrafluoroethylene dural substitute versus pericranial autograft. Childs Nerv Syst. 2009;25(2):183-90.
- 7. He Y, Revel M, Loty B. A quantitative model of post-laminectomy scar formation. Effects of a nonsteroidal anti-inflammatory drug. Spine (Phila Pa 1976). 1995;20(5):557-63; discussion 79-80.
- 8. LaRocca H, Macnab I. The laminectomy membrane. Studies in its evolution, characteristics, effects, and prophylaxis in dogs. J Bone Joint Surg Br. 1974;56b(3):545-50.
- 9. Özgül Önal M, Yiğittürk Y, Elbe H, et al. Leptinin yara iyileşmesi üzerine in vitro etkisinin büyüme faktörleri üzerinden incelenmesi. Muğla Sıtkı Koçman Üni Tıp Derg. 2023;10(1):19-28.
- 10. Kocabaş M. Alparslan Ş, Çokluk C, et al. Tavşanlarda laminektomi sonrası yapışıklığın önlenmesinde Gore-Tex cerrahi membran kullanılması. Türk Nöro Derg. 1999;9(1):42-6.
- 11. Robertson JT, Meric AL, Dohan FC, et al. The reduction of postlaminectomy peridural fibrosis in rabbits by a carbohydrate polymer. J Neurosurg. 1993;79(1):89-95.
- 12. Maurer PK and McDonald JV. Vicryl (polyglactin 910) mesh as a dural substitute. J Neurosurg. 1985;63(3):448-52.
- 13. Yong-Hing K, Reilly J, de Korompay V, et al. Prevention of nerve root adhesions after laminectomy. Spine (Phila Pa 1976). 1980;5(1):59-64.
- 14. Chen PQ, Yang CY, Su CJ, et al. Prevention of postlaminectomy membrane: experimental and clinical observations. Taiwan Yi Xue Hui Za Zhi. 1989;88(1):57-61.
- 15. Esmonde T, Lueck CJ, Symon L, et al. Creutzfeldt-Jakob disease and lyophilised dura mater grafts: report of two cases. J Neurol Neurosurg Psychiatry. 1993;56(9):999-1000.
- 16. Masullo C, Pocchiari M, Macchi G, et al. Transmission of Creutzfeldt-Jakob disease by dural cadaveric graft. J Neurosurg. 1989;71(6):954-5.
- 17. Leads from the MMWR. Creutzfeldt-Jakob disease in a second patient who received a cadaveric dura mater graft. Jama. 1989;261(8):1118.
- 18. Pritchard J. TV, Kalb R. Rapidly progressive dementia in a patient who received a cadaveric dura mater graft. MMWR Morb Mortal Wkly Rep. 1987;36(4):49-50,55.
- 19. Thadani V, Penar PL, Partington J, et al. Creutzfeldt-Jakob disease is probably acquired from a cadaveric dura mater graft. Case report. J Neurosurg. 1988;69(5):766-9.
- 20. Nordstrom MR, Wang TD, Neel HB. Dura mater for soft-tissue augmentation. Evaluation in a rabbit model. Arch Otolaryngol Head Neck Surg. 1993;119(2):208-14.
- 21. Harada Y, Imai Y, Kurosawa H, et al. Long-term results of the clinical use of an expanded polytetrafluoroethylene surgical membrane as a pericardial substitute. J Thorac Cardiovasc Surg. 1988;96(5):811-5.
- 22. Minale C, Nikol S, Hollweg G, et al. Clinical experience with expanded polytetrafluoroethylene Gore-Tex surgical membrane for pericardial closure: a study of 110 cases. J Card Surg. 1988;3(3):193-201.
- 23. Takci E. Kadıoglu HH, Bahceci H, et al. Deneysel kraniyal dural defektlerin onarımında dehidrate human dura mater greftlerinin kullanımı histopatolojik değerlendirme. Türk Nöro Derg. 2001;11(3):178-84.
- 24. Ozveren MF. Turkmen CS, Tanik C, et al. Experimental use of polytetrafluoroethylene graft for prevention of peridural fibrosis in dogs. Türk Nöro Derg. 1999;9(2):25-33.
- 25. Topsakal C, Akpolat N, Erol FS, et al. Seprafilm is superior to Gore-Tex in the prevention of peridural fibrosis. J Neurosurg. 2004;101(2):295-302.
Abstract
Spinal dural defektlerin onarılmasında zaman zaman dura greftlerine ihtiyaç duyulmaktadır. Duraplasti için ideal bir materyal arayışı halen tartışmalı bir konudur. Bu çalışmada Wistar-Albino cinsi, 260-380 gr ağırlığında, 26 adet erişkin erkek sıçanlar kullanılmıştır. Sıçanlar, Kontrol (n=10), Fasya (n=6) ve Gore-Tex (politetrafloroetilen) Cerrahi Membran (n=10) grupları olmak üzere üç gruba ayrılmışlardır. Sıçanlara laminektomi uygulanıp, dura defekti yaratılmış ve daha sonra sırasıyla 'defekt açık bırakılmış', 'fasya ile duraplastı' ve 'Gore-Tex cerrahi membran ile duraplasti' uygulanmıştır. Cerrahi operasyon sonrası 60. günde, sıçanlara ötenazi uygulanmış ve operasyon bölgesinde granülasyon dokusu ve yapışıklıkların değerlendirilmesi amacıyla histopatolojik incelemeler yapılmıştır. Her üç grupta da defekt bölgesini granülasyon dokusunun doldurduğu görülmüştür. Fasya grubunda, fasyanın dura mater ve nöral doku ile granülasyon dokusu arasında bir bariyer teşkil ettiği ancak yoğun granülasyon dokusuyla dolduğu ve yapışıklık olduğu gözlenmiştir. Gore-Tex cerrahi membran grubunda ise Gore-Tex cerrahi membranın dura mater ve nöral doku ile granülasyon dokusu arasında yapışıklığı önleyen iyi bir fiziksel bariyer oluşturduğu, granülasyon dokusunun Gore-Tex cerrahi membrana yapışmadığı bulunmuştur.
Keywords
Ethical Statement
Etik Onay: Ege Üniversitesi Hayvan Deneyleri Yerel Etik Kurulun’dan çalışma için gerekli onay alınmıştır. (12.03.2002 tarih ve 2002.08 sayı)
Thanks
TEŞEKKÜR: Bu çalışmanın ortaya konmasında büyük katkıları olan Sayın Dr. Mine Tunakan’a teşekkürlerimizi sunarız. AÇIKLAMA: Bu çalışma, 19-22 Ekim 2023 tarihlerinde Antalya, Türkiye'de düzenlenen Sinir Sistemi Cerrahisi Derneği 19. Bilimsel Kongresi'nde ‘Yılın Bildirileri’ oturumunda sunulmuş olup, ‘İkincilik’ ödülü almıştır.
References
- 1. Park YK, Tator CH. Prevention of arachnoiditis and postoperative tethering of the spinal cord with Gore-Tex surgical membrane: an experimental study with rats. Neurosurgery. 1998;42(4):813-23; discussion 23-4.
- 2. Thammavaram KV, Benzel EC, Kesterson L. Fascia lata graft as a dural substitute in neurosurgery. South Med J. 1990;83(6):634-6.
- 3. Keller JT, Ongkiko CM Jr, Saunders MC, et al. Repair of spinal dural defects. An experimental study. J Neurosurg. 1984;60(5):1022-8.
- 4. Kurt G, Cemil B, Celik B, et al. Comparison of Oxiplex and Gore-Tex effectivity in an experimental peridural fibrosis model. Neurocirugia (Astur). 2009;20(4):360-6.
- 5. Vakis A, Koutentakis D, Karabetsos D, et al. Use of polytetrafluoroethylene dural substitute as adhesion preventive material during craniectomies. Clin Neurol Neurosurg. 2006;108(8):798-802.
- 6. Attenello FJ, McGirt MJ, Garcés-Ambrossi GL, et al. Suboccipital decompression for Chiari I malformation: outcome comparison of duraplasty with expanded polytetrafluoroethylene dural substitute versus pericranial autograft. Childs Nerv Syst. 2009;25(2):183-90.
- 7. He Y, Revel M, Loty B. A quantitative model of post-laminectomy scar formation. Effects of a nonsteroidal anti-inflammatory drug. Spine (Phila Pa 1976). 1995;20(5):557-63; discussion 79-80.
- 8. LaRocca H, Macnab I. The laminectomy membrane. Studies in its evolution, characteristics, effects, and prophylaxis in dogs. J Bone Joint Surg Br. 1974;56b(3):545-50.
- 9. Özgül Önal M, Yiğittürk Y, Elbe H, et al. Leptinin yara iyileşmesi üzerine in vitro etkisinin büyüme faktörleri üzerinden incelenmesi. Muğla Sıtkı Koçman Üni Tıp Derg. 2023;10(1):19-28.
- 10. Kocabaş M. Alparslan Ş, Çokluk C, et al. Tavşanlarda laminektomi sonrası yapışıklığın önlenmesinde Gore-Tex cerrahi membran kullanılması. Türk Nöro Derg. 1999;9(1):42-6.
- 11. Robertson JT, Meric AL, Dohan FC, et al. The reduction of postlaminectomy peridural fibrosis in rabbits by a carbohydrate polymer. J Neurosurg. 1993;79(1):89-95.
- 12. Maurer PK and McDonald JV. Vicryl (polyglactin 910) mesh as a dural substitute. J Neurosurg. 1985;63(3):448-52.
- 13. Yong-Hing K, Reilly J, de Korompay V, et al. Prevention of nerve root adhesions after laminectomy. Spine (Phila Pa 1976). 1980;5(1):59-64.
- 14. Chen PQ, Yang CY, Su CJ, et al. Prevention of postlaminectomy membrane: experimental and clinical observations. Taiwan Yi Xue Hui Za Zhi. 1989;88(1):57-61.
- 15. Esmonde T, Lueck CJ, Symon L, et al. Creutzfeldt-Jakob disease and lyophilised dura mater grafts: report of two cases. J Neurol Neurosurg Psychiatry. 1993;56(9):999-1000.
- 16. Masullo C, Pocchiari M, Macchi G, et al. Transmission of Creutzfeldt-Jakob disease by dural cadaveric graft. J Neurosurg. 1989;71(6):954-5.
- 17. Leads from the MMWR. Creutzfeldt-Jakob disease in a second patient who received a cadaveric dura mater graft. Jama. 1989;261(8):1118.
- 18. Pritchard J. TV, Kalb R. Rapidly progressive dementia in a patient who received a cadaveric dura mater graft. MMWR Morb Mortal Wkly Rep. 1987;36(4):49-50,55.
- 19. Thadani V, Penar PL, Partington J, et al. Creutzfeldt-Jakob disease is probably acquired from a cadaveric dura mater graft. Case report. J Neurosurg. 1988;69(5):766-9.
- 20. Nordstrom MR, Wang TD, Neel HB. Dura mater for soft-tissue augmentation. Evaluation in a rabbit model. Arch Otolaryngol Head Neck Surg. 1993;119(2):208-14.
- 21. Harada Y, Imai Y, Kurosawa H, et al. Long-term results of the clinical use of an expanded polytetrafluoroethylene surgical membrane as a pericardial substitute. J Thorac Cardiovasc Surg. 1988;96(5):811-5.
- 22. Minale C, Nikol S, Hollweg G, et al. Clinical experience with expanded polytetrafluoroethylene Gore-Tex surgical membrane for pericardial closure: a study of 110 cases. J Card Surg. 1988;3(3):193-201.
- 23. Takci E. Kadıoglu HH, Bahceci H, et al. Deneysel kraniyal dural defektlerin onarımında dehidrate human dura mater greftlerinin kullanımı histopatolojik değerlendirme. Türk Nöro Derg. 2001;11(3):178-84.
- 24. Ozveren MF. Turkmen CS, Tanik C, et al. Experimental use of polytetrafluoroethylene graft for prevention of peridural fibrosis in dogs. Türk Nöro Derg. 1999;9(2):25-33.
- 25. Topsakal C, Akpolat N, Erol FS, et al. Seprafilm is superior to Gore-Tex in the prevention of peridural fibrosis. J Neurosurg. 2004;101(2):295-302.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Original Article |
| Authors | |
| Publication Date | April 30, 2024 |
| Submission Date | November 4, 2023 |
| Acceptance Date | February 8, 2024 |
| Published in Issue | Year 2024 Volume: 11 Issue: 1 |
