AlloDerm for duraplasty in Chiari malformation: superior outcomes

详细信息    查看全文

• 作者：Christian A. Bowers ; Cameron Brimley ; Chad Cole ; Wayne Gluf…
• 关键词：AlloDerm ; Chiari decompression ; Duraplasty ; Dural grafts
• 刊名：Acta Neurochirurgica
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：157
• 期：3
• 页码：507-511
• 全文大小：225 KB
• 参考文献：1. Abla AA, Link T, Fusco D, Wilson DA, Sonntag VK (2010) Comparison of dural grafts in Chiari decompression surgery: Review of the literature. J Craniovertebr Junction Spine 1:29-7 CrossRef
  2. Acerbi F, Genden E, Bederson J (2010) Circumferential watertight dural repair using nitinol U-clips in expanded endonasal and sublabial approaches to the cranial base. Neurosurgery 67:448-56 CrossRef
  3. Agag RL, Granick MS, Omidi M, Catrambone J, Benevenia J (2004) Neurosurgical reconstruction with acellular cadaveric dermal matrix. Ann Plast Surg 52:571-77 CrossRef
  4. Danish SF, Samdani A, Hanna A, Storm P, Sutton L (2006) Experience with acellular human dura and bovine collagen matrix for duraplasty after posterior fossa decompression for Chiari malformations. J Neurosurg 104:16-0
  5. Klekamp J (2012) Surgical treatment of Chiari I malformation–analysis of intraoperative findings, complications, and outcome for 371 foramen magnum decompressions. Neurosurgery 71:365-80, discussion 380 CrossRef
  6. Lam FC, Kasper E (2012) Augmented autologous pericranium duraplasty in 100 posterior fossa surgeries—a retrospective case series. Neurosurgery 71:ons302–ons307 CrossRef
  7. Parker SL, Godil SS, Zuckerman SL, Mendenhall SK, Tulipan NB, McGirt MJ (2013) Effect of symptomatic pseudomeningocele on improvement in pain, disability, and quality of life following suboccipital decompression for adult Chiari malformation Type I. J Neurosurg 119:1159-1165
  8. Shah AR, Pearlman AN, O'Grady KM, Bhattacharyya TK, Toriumi DM (2007) Combined use of fibrin tissue adhesive and acellular dermis in dural repair. Am J Rhinol 21:619-21 CrossRef
  9. Tubbs R, Oakes W (2004) Chiari malformations. In: Winn H (ed) Youman's Neurological Surgery. Saunders, Philadelphia, pp 3347-361
  10. Warren WL, Medary MB, Dureza CD, Bellotte JB, Flannagan PP, Oh MY, Fukushima T (2000) Dural repair using acellular human dermis: experience with 200 cases: technique assessment. Neurosurgery 46:1391-396 CrossRef
  11. Wong AK, Schonmeyr B, Singh P, Carlson DL, Li S, Mehrara BJ (2008) Histologic analysis of angiogenesis and lymphangiogenesis in acellular human dermis. Plast Reconstr Surg 121:1144-152 CrossRef
  
• 刊物主题：Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery;
• 出版者：Springer Vienna
• ISSN：0942-0940

文摘

Background Autologous pericranium, fascia lata?(either as autograft or allograft), bovine pericardium (DuraGuard), fetal bovine tissue (Durepair), processed collagen matrix (DuraGen), and synthetic fabrics (e.g., synthetic Goretex graft) have all been used for duraplasty in Chiari decompression surgery, and no consensus exists as to the optimal material. We reviewed our experience to compare the incidence of graft-related complications associated with using acellular human dermis allograft (AlloDerm) with those of DuraGuard, DuraGen, and Durepair. Methods In a retrospective cohort chart review, our cohort included 119 patients who underwent 128 Chiari decompression procedures by a single surgeon from January 1, 1997, through July 31, 2012. Age, sex, smoking status, weight, and the type of dural graft used were analyzed with univariate statistical tests. Dural grafts were selected based on the commercial products available at the time of surgery during this 15-year period. Results The reoperation rate for cerebrospinal fluid leak causing pseudomeningocele was 2.2?% (1/46 cases) with the AlloDerm graft and 17.1?% (14/82 cases) with other materials (p--.01). Each of the non-AlloDerm grafts had a higher reoperation rate than AlloDerm when analyzed separately. Not using AlloDerm was the only statistically significant factor for the need for reoperation (p--.01). Conclusions The use of the AlloDerm dural graft for duraplasty in Chiari decompressions resulted in a significantly lower pseudomeningocele formation than the use of any other type of dural graft. There was no association between patient age, sex, extra weight, or smoking status and the need for reoperation.