Calikoglu Cagatay, Cakir Murteza, Tuzun Yusuf
Department of Neurosurgery, Atatürk University School of Medicine, Erzurum, Turkey.
Department of Neurosurgery, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
Eurasian J Med. 2019 Jun;51(2):133-138. doi: 10.5152/eurasianjmed.2018.17422. Epub 2018 Dec 3.
This study investigated the suitability of the collagen matrix as a dural graft in the repair of experimental spinal dura mater defects.
In the study, 30 New Zealand white rabbits were used. The rabbits were divided into a study and control group. In both groups, following exact laminectomy (Th 10 and 11) in rabbits under the isoflorane anesthesia, a spinal dural defect 1×0.5 cm in size was formed. In the study group, the dura mater defect was covered with collagen matrix; in the control group, the excised dura was sutured back to its original position. At the end of the follow-up period, the rabbits were sacrificed. In all subjects, the vertebral colon was excised completely, and it was fixed in 10% formaldehyde solution. Sections 3 pm thick were taken from the specimens, stained with hematoxylin and eosin, and examined under a light microscope. The stained sections were evaluated under light microscopy with regard to the cellular inflammatory response, fibroblastic proliferation, foreign body reaction, and capsule formation.
The collagen matrix was completely absorbed, and it was easy to use since it did not require sutures. Foreign body reactions were minimal in the early period and were resolved entirely in the end. Inflammatory response against the collagen matrix was no greater than in the control group in which the dura was sutured primarily and then closed, eventually disappearing entirely, and no adhesion formation resulted. Collagen permits successful regeneration by combining with the dura mater. No capsule formation was observed in either group.
This study shows that collagen is suitable for duraplastic procedures and that it may be a useful agent in patients in whom the dura cannot be closed primarily due to retraction, constriction, or excision.
本研究调查胶原基质作为硬脊膜移植物修复实验性脊柱硬脊膜缺损的适用性。
本研究使用了30只新西兰白兔。将兔子分为研究组和对照组。两组均在异氟烷麻醉下对兔子进行精确的椎板切除术(第10和11胸椎),形成大小为1×0.5 cm的脊柱硬脊膜缺损。研究组用胶原基质覆盖硬脊膜缺损;对照组将切除的硬脊膜缝合回原位。随访期结束时,处死兔子。对所有实验对象,完整切除椎结肠,并将其固定在10%甲醛溶液中。从标本上切取3μm厚的切片,用苏木精和伊红染色,在光学显微镜下检查。对染色切片在光学显微镜下评估细胞炎症反应、成纤维细胞增殖、异物反应和包膜形成情况。
胶原基质完全被吸收,且由于无需缝合易于使用。早期异物反应最小,最终完全消退。对胶原基质的炎症反应不大于硬脊膜首先缝合然后闭合的对照组,最终炎症反应完全消失,且未形成粘连。胶原与硬脊膜结合可成功实现再生。两组均未观察到包膜形成。
本研究表明胶原适用于硬脊膜成形手术,对于因回缩、狭窄或切除而无法一期闭合硬脊膜的患者,它可能是一种有用的材料。