title: Pial and arachnoid welding for restoration of normal cord anatomy after excision of intramedullary spinal cord tumors.
abstract: 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.
authors.affiliation: Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore 632004, India. agchacko@cmcvellore.ac.in
authors.forename: Ari George
authors.initials: AG
authors.lastname: Chacko
authors.forename: Roy Thomas
authors.initials: RT
authors.lastname: Daniel
authors.forename: Geeta
authors.initials: G
authors.lastname: Chacko
authors.forename: Krothapalli Srinivasa
authors.initials: KS
authors.lastname: Babu
mesh_terms: 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*