Prevention of arachnoiditis and postoperative tethering of the spinal cord with Gore-Tex surgical membrane: An experimental study with rats

Youn-Kwan Park, Charles H. Tator

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

OBJECTIVE: Arachnoidal adhesions and inflammation were evaluated in 72 rats after spinal dural repair with one of three materials, i.e., Gore-Tex surgical membrane, collagen-coated Vicryl mesh, or lyophilized spinal dural allograft. METHODS: Laminectomy at L1 was performed, and then a 3- x 4-mm segment of spinal dura mater and arachnoid membrane was excised. After implantation of the dural substitute, the animals were divided into normal and injured groups. In the injured group, a spinal cord injury was produced at the midpoint of the duraplasty site by the clip compression technique, with 25-g force for 1 minute. Neurological performance was assessed by the inclined plane technique, and groups of rats were killed at 8 to 24 weeks after surgery. The spinal column was removed en bloc and processed for histological examination. RESULTS: There were no differences in neurological function among the three dural substitutes in either injured or noninjured rats. However, there were major differences among the groups in the incidence and severity of arachnoid adhesions and tethering. The neural tissue was bound to a thick neomembrane surrounding the lyophilized dural allograft and the collagen-coated Vicryl mesh. In contrast, the Gore-Tex surgical membrane induced only a thin membranous adhesion, which was loose and flexible. The inflammatory and foreign body response was most pronounced in rats treated with collagen-coated Vicryl mesh, at 8 and 24 weeks. CONCLUSION: In the present study, Gore-Tex surgical membrane was a very good material for the surgical repair of spinal dural defects. Additional experimental studies are required to compare Gore-Tex membrane with autologous tissues.

Original languageEnglish
Pages (from-to)813-824
Number of pages12
JournalNeurosurgery
Volume42
Issue number4
DOIs
Publication statusPublished - 1998 Apr 1
Externally publishedYes

Fingerprint

Arachnoiditis
Spinal Cord
Polyglactin 910
Membranes
Arachnoid
Collagen
Allografts
Dura Mater
Laminectomy
Foreign Bodies
Spinal Cord Injuries
Surgical Instruments
Spine
Inflammation
Incidence

Keywords

  • Collagen-coated Vicryl mesh
  • Dural repair
  • Dural substitute
  • Gore-Tex surgical membrane
  • Lyophilized dura
  • Spinal cord

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Prevention of arachnoiditis and postoperative tethering of the spinal cord with Gore-Tex surgical membrane : An experimental study with rats. / Park, Youn-Kwan; Tator, Charles H.

In: Neurosurgery, Vol. 42, No. 4, 01.04.1998, p. 813-824.

Research output: Contribution to journalArticle

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AB - OBJECTIVE: Arachnoidal adhesions and inflammation were evaluated in 72 rats after spinal dural repair with one of three materials, i.e., Gore-Tex surgical membrane, collagen-coated Vicryl mesh, or lyophilized spinal dural allograft. METHODS: Laminectomy at L1 was performed, and then a 3- x 4-mm segment of spinal dura mater and arachnoid membrane was excised. After implantation of the dural substitute, the animals were divided into normal and injured groups. In the injured group, a spinal cord injury was produced at the midpoint of the duraplasty site by the clip compression technique, with 25-g force for 1 minute. Neurological performance was assessed by the inclined plane technique, and groups of rats were killed at 8 to 24 weeks after surgery. The spinal column was removed en bloc and processed for histological examination. RESULTS: There were no differences in neurological function among the three dural substitutes in either injured or noninjured rats. However, there were major differences among the groups in the incidence and severity of arachnoid adhesions and tethering. The neural tissue was bound to a thick neomembrane surrounding the lyophilized dural allograft and the collagen-coated Vicryl mesh. In contrast, the Gore-Tex surgical membrane induced only a thin membranous adhesion, which was loose and flexible. The inflammatory and foreign body response was most pronounced in rats treated with collagen-coated Vicryl mesh, at 8 and 24 weeks. CONCLUSION: In the present study, Gore-Tex surgical membrane was a very good material for the surgical repair of spinal dural defects. Additional experimental studies are required to compare Gore-Tex membrane with autologous tissues.

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