Lauvin Marie-Agnès, Zemmoura Ilyess, Cazals Xavier, Cottier Jean-Philippe
Department of Neuroradiology, CHRU de Tours, CHRU Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France.
Department of Neurosurgery, CHRU de Tours, CHRU Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France.
Spine J. 2015 Jan 1;15(1):e5-8. doi: 10.1016/j.spinee.2014.09.012. Epub 2014 Sep 28.
Bovine serum albumin and glutaraldehyde (BSAG) (BioGlue) is a surgical adhesive widely used for off-label applications in neurosurgical procedures to minimize the risk of cerebrospinal fluid leakage after dural closure.
To describe magnetic resonance imaging (MRI) and computed tomography (CT) aspects of two cases of postoperative BSAG expansion causing delayed cauda equina compression requiring further surgery.
A case report.
Two cases of delayed cauda equina compression complicating the closure, with BSAG, of small unintentional tears in the dura requiring lumbar decompressive surgery.
They included postoperative CT and MRI findings.
We compared postoperative imaging and perioperative findings during subsequent surgery.
In both cases, imaging showed cauda equina compression due to epidural masses found during subsequent surgery comprising BioGlue. These masses appeared slightly hyperdense on CT scans and markedly hypointense on T2-weighted MRI scans.
When applied as a thick layer during use as a dural sealant, BSAG may swell, leading to a symptomatic "glue-oma" giving a hypointense image on T2-weighted MRI scans.
牛血清白蛋白和戊二醛（BSAG）（生物胶）是一种外科粘合剂，广泛用于神经外科手术的非标签应用，以降低硬脑膜闭合后脑脊液漏的风险。
描述两例术后BSAG膨胀导致马尾神经受压延迟并需要进一步手术的磁共振成像（MRI）和计算机断层扫描（CT）表现。
病例报告。
两例因使用BSAG闭合硬脑膜小的意外撕裂而导致马尾神经受压延迟，需要进行腰椎减压手术。
包括术后CT和MRI表现。
我们比较了术后影像学检查结果和后续手术中的围手术期发现。
在两例病例中，影像学检查均显示后续手术中发现的硬膜外肿块导致马尾神经受压，肿块主要由生物胶组成。这些肿块在CT扫描上呈稍高密度，在T2加权MRI扫描上呈明显低信号。
当作为硬脑膜密封剂使用时，如果涂抹成厚层，BSAG可能会膨胀，导致出现有症状的“胶瘤”，在T2加权MRI扫描上呈现低信号影像。
