Pial and arachnoid welding for restoration of normal cord anatomy after excision of intramedullary spinal cord tumors.
A significant postoperative problem in patients undergoing excision of intramedullary tumors is painful dysesthesiae, attributed to various causes, including edema, arachnoid scarring and cord tethering. The authors describe a technique of welding the pia and arachnoid after the excision of intramedullary spinal cord tumors used in seven cases. Using a fine bipolar forcep and a low current, the pial edges of the myelotomy were brought together and welded under saline irrigation. A similar method was used for closing the arachnoid while the dura was closed with a running 5-0 vicryl suture. Closing the pia and arachnoid restores normal cord anatomy after tumor excision and may reduce the incidence of postoperative painful dysesthesiae.
Chacko
Ari George
AG
Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore 632004, India. agchacko@cmcvellore.ac.in
Daniel
Roy Thomas
RT
Chacko
Geeta
G
Babu
Krothapalli Srinivasa
KS
D000328:Adult; D001099:Arachnoid / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010841:Pia Mater / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013116:Spinal Cord / Q000033:anatomy & histology; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D018608:Ultrasonography, Doppler / Q000379:methods; D014896:Welding / Q000379:methods*