Total dura substitute in the spine: double layer dural substitute made from polylactide layer and bovine pericardium.
When there is significant loss of spinal dura mater, dural substitution with synthetic or allogenic materials is essential. In the case of laminectomy, mechanical protection and reformation of the dorsal spinal canal may be useful. This is a report on a patient with total dura loss through tumour atrophy of the dura and laminae. In order to reconstruct the dorsal face of the spinal canal a polylactide sheet was cut and shaped to fit the physiological contour. A bovine dura substitute was firmly attached and sutured to the inner surface of the polylactide shield. The implant was wedged in between the pedicles and the facet joints and resulted in a water-tight dura substitute maintaining the shape of the spinal canal and protecting it against mechanical forces and intradural scar formation.
Hoell
T
T
Spine Center Baden, Mittelbaden Hospital, Baden-Baden, Germany. hoell@klinikum-mittelbaden.de
Hohaus
C
C
Huschak
G
G
Beier
A
A
Meisel
H-J
HJ
D020341:Absorbable Implants; D001284:Atrophy; D001684:Biological Dressings; D001705:Bioprosthesis; D004388:Dura Mater / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D010236:Paraganglioma, Extra-Adrenal / Q000175:diagnosis / Q000601:surgery*; D011091:Polyesters; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012086:Reoperation; D013115:Spinal Canal / Q000601:surgery*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed
D011091:Polyesters; C033616:poly(lactide)