Role of Pericardial Patch in Neurosurgery: Institutional Experience

Abstract

Introduction: Dural closure is an important part of neurosurgery, failure which may lead to wound infection, pseudomeningoceles, meningitis, severe morbidity to a patient, and even mortality. In cases where primary dura closure is not possible, a bovine pericardial patch is a good alternative with the benefits of suturability and the ability to provide watertight closure, hence preventing Cerebrospinal Fluid (CSF) leak. The present study demonstrates the use of the bovine pericardial patch in both cranial and spinal disorders for dural closure as well as for transposition technique in microvascular decompression. Objectives: The aim of our study is to understand the advantages and feasibility of a bovine pericardial patch in various neurosurgical procedures. Material & Methods: Fifty-one patients were analyzed prospectively and followed up in which glutaraldehyde-free bovine pericardial patch was used in various cranial and spinal disorders. Results: The most common indications where a bovine pericardial patch was used, in decreasing order of frequency, were meningioma excision surgery (47%), followed by Chiari malformation operated for foramen magnum decompression (17.6%), meningomyelocele (7.8%), spinal dural defects (7.8%), trigeminal neuralgia (5.8%), traumatic decompression with lax duraplasty (4%), glioma (4%), encephalocele (4%), and skull base defects (2%). Two patients had complications, one with CSF leak and the other had superficial wound infection, which were managed appropriately. Conclusions: The use of a bovine pericardial patch as a dural substitute in various cranial and spinal disorders is feasible with good outcomes, and it can be considered an ideal dural substitute.