Repair of spinal dural defects

Abstract

✓ The search for an ideal substance for duraplasty has stimulated clinical and experimental investigations. To date a large number of materials have been employed for dural repair, although there is as yet no unanimity regarding the ideal material. Most of these studies have been concerned with cranial dura, and spinal duraplasty has received less attention. This study was designed to examine the repair of spinal dural defects in the dog. The materials chosen for this experiment were autologous fat, a polyester fiber mesh (Mersilene) and siliconecoated Dacron (Dura Film). Nineteen dogs were used in this study. Following lumbar laminectomy and the excision of elliptical pieces of dura (1.0 × 0.5 cm) at three noncontiguous levels, each of the defects was repaired using one of the three materials. Groups of animals were sacrificed at each of 3, 6, 12, and 24 weeks after dural repair. The lumbar region was removed en bloc and prepared for histological examination. Repair of the dural opening was achieved in all cases. The polyester fiber mesh was quite effective for dural repair, serving as a scaffold through which a neomembrane grew and united the dural edges. The results with autologous fat were similarly favorable. On the other hand, results with silicone-coated Dacron showed encapsulation by connective tissue, with the ventral aspect of the graft frequently compressing the underlying cord.