STUDY DESIGN: This report describes four cases of symptomatic cerebral spinal fluid leak after lumbar microdiscectomy where ADCON-L was used. OBJECTIVES: To report that ADCON-L may exacerbate cerebral spinal fluid leak from unrecognized, small dural tears after lumbar discectomy. SUMMARY OF BACKGROUND DATA: ADCON-L is a porcine-derived polyglycan that is used with increasing frequency in spinal surgery. It is advocated to reduce postoperative peridural fibrosis and adhesions. METHODS: Four cases of symptomatic cerebral spinal fluid leak after lumbar microdiscectomy were identified. Information on these patients was obtained by chart review. RESULTS: Three patients had small, inadvertent durotomies that were not appreciated at surgery even with the aid of a microscope. The dural violation in the fourth patient occurred at the previous epidural steroid injection site located on the contralateral side of the laminotomy. CONCLUSION: ADCON-L may inhibit dural healing and exacerbate cerebral spinal fluid leak from microscopic durotomies not recognized at the time of surgery.
STUDY DESIGN: This report describes four cases of symptomatic cerebral spinal fluid leak after lumbar microdiscectomy where ADCON-L was used. OBJECTIVES: To report that ADCON-L may exacerbate cerebral spinal fluid leak from unrecognized, small dural tears after lumbar discectomy. SUMMARY OF BACKGROUND DATA: ADCON-L is a porcine-derived polyglycan that is used with increasing frequency in spinal surgery. It is advocated to reduce postoperative peridural fibrosis and adhesions. METHODS: Four cases of symptomatic cerebral spinal fluid leak after lumbar microdiscectomy were identified. Information on these patients was obtained by chart review. RESULTS: Three patients had small, inadvertent durotomies that were not appreciated at surgery even with the aid of a microscope. The dural violation in the fourth patient occurred at the previous epidural steroid injection site located on the contralateral side of the laminotomy. CONCLUSION: ADCON-L may inhibit dural healing and exacerbate cerebral spinal fluid leak from microscopic durotomies not recognized at the time of surgery.
Authors: Claudia Cencetti; Davide Bellini; Cristina Longinotti; Andrea Martinelli; Pietro Matricardi Journal: J Mater Sci Mater Med Date: 2011-01-08 Impact factor: 3.896
Authors: Gerd M Ivanic; Peter T Pink; Frank Schneider; Markus Stuecker; Nicolaus C Homann; Klaus W Preidler Journal: Eur Spine J Date: 2006-06-09 Impact factor: 3.134