Cagatay Calikoglu1, Murteza Cakir1, Yusuf Tuzun2. 1. Department of Neurosurgery, Atatürk University School of Medicine, Erzurum, Turkey. 2. Department of Neurosurgery, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
Abstract
OBJECTIVE: This study investigated the suitability of the collagen matrix as a dural graft in the repair of experimental spinal dura mater defects. MATERIALS AND METHODS: In the study, 30 New Zealand white rabbits were used. The rabbits were divided into a study and control group. In both groups, following exact laminectomy (Th 10 and 11) in rabbits under the isoflorane anesthesia, a spinal dural defect 1×0.5 cm in size was formed. In the study group, the dura mater defect was covered with collagen matrix; in the control group, the excised dura was sutured back to its original position. At the end of the follow-up period, the rabbits were sacrificed. In all subjects, the vertebral colon was excised completely, and it was fixed in 10% formaldehyde solution. Sections 3 pm thick were taken from the specimens, stained with hematoxylin and eosin, and examined under a light microscope. The stained sections were evaluated under light microscopy with regard to the cellular inflammatory response, fibroblastic proliferation, foreign body reaction, and capsule formation. RESULTS: The collagen matrix was completely absorbed, and it was easy to use since it did not require sutures. Foreign body reactions were minimal in the early period and were resolved entirely in the end. Inflammatory response against the collagen matrix was no greater than in the control group in which the dura was sutured primarily and then closed, eventually disappearing entirely, and no adhesion formation resulted. Collagen permits successful regeneration by combining with the dura mater. No capsule formation was observed in either group. CONCLUSION: This study shows that collagen is suitable for duraplastic procedures and that it may be a useful agent in patients in whom the dura cannot be closed primarily due to retraction, constriction, or excision.
OBJECTIVE: This study investigated the suitability of the collagen matrix as a dural graft in the repair of experimental spinal dura mater defects. MATERIALS AND METHODS: In the study, 30 New Zealand white rabbits were used. The rabbits were divided into a study and control group. In both groups, following exact laminectomy (Th 10 and 11) in rabbits under the isoflorane anesthesia, a spinal dural defect 1×0.5 cm in size was formed. In the study group, the dura mater defect was covered with collagen matrix; in the control group, the excised dura was sutured back to its original position. At the end of the follow-up period, the rabbits were sacrificed. In all subjects, the vertebral colon was excised completely, and it was fixed in 10% formaldehyde solution. Sections 3 pm thick were taken from the specimens, stained with hematoxylin and eosin, and examined under a light microscope. The stained sections were evaluated under light microscopy with regard to the cellular inflammatory response, fibroblastic proliferation, foreign body reaction, and capsule formation. RESULTS: The collagen matrix was completely absorbed, and it was easy to use since it did not require sutures. Foreign body reactions were minimal in the early period and were resolved entirely in the end. Inflammatory response against the collagen matrix was no greater than in the control group in which the dura was sutured primarily and then closed, eventually disappearing entirely, and no adhesion formation resulted. Collagen permits successful regeneration by combining with the dura mater. No capsule formation was observed in either group. CONCLUSION: This study shows that collagen is suitable for duraplastic procedures and that it may be a useful agent in patients in whom the dura cannot be closed primarily due to retraction, constriction, or excision.
Entities:
Keywords:
Collagen; dural substitute; spinal dura mater
Authors: S J Palm; W M Kirsch; Y H Zhu; N Peckham; S Kihara; R Anton; T Anton; K Balzer; T Eickmann Journal: Neurosurgery Date: 1999-10 Impact factor: 4.654