scholarly journals P.094 Spinal dural repair: a Canadian questionnaire

2017 ◽  
Vol 44 (S2) ◽  
pp. S37-S37 ◽  
Author(s):  
K Reddy ◽  
S Almenawar ◽  
M Aref ◽  
CT Oitment
Keyword(s):  
Nerve Root ◽  
Spinal Surgery ◽  
Comparative Research ◽  
Research Study ◽  
Response Rate ◽  
Bed Rest ◽  
Optimal Management ◽  
Dural Tear ◽  
Dural Repair ◽  
Dural Tears

Background: Iatrogenic dural tear a complication of spinal surgery with significant morbidity and cost to the healthcare system. The optimal management is unclear, and therefore we aimed to survey current practices among Canadian practitioners. Methods: A questionnaire was administered to members of the Canadian Neurological Surgeon’s Society designed to explore methods of closure of iatrogenic durotomy. Results: Spinal surgeons were surveyed with a 55% response rate (n=91). For pinhole sized tears there is a trend toward sealant fixation(36.7%). Medium and large sized tears are predominantly closed with sutures and sealant(67% and 80%, respectively). Anterior tears are managed using sealant alone(48%). Posterior tears are treated with a combination of sutures and sealant(73.8%). Nerve root tears are treated with either sealant alone(50%). Most respondents recommended bed rest for at least 24 hours in the setting of medium(73.2%) and large(89.1%) dural tears. Conclusions: This study elucidates the areas of uncertainty with regard to iatrogenic dural tear management. There is disagreement regarding management of anterior and nerve root tears, pin-hole sized tears in any location of the spine, and whether patients should be admitted to hospital or on bed-rest following a pin-hole sized dural tear. There is a need for a robust comparative research study of dural repair strategies.

Remote Cerebellar Hemorrhage after a Spinal Surgery Complicated by Dural Tear: Case Report and Literature Review

2005 ◽  
Vol 57 (suppl_1) ◽  
pp. E215-E215 ◽  
Author(s):  
Oguz Karaeminogullari ◽  
Basar Atalay ◽  
Orcun Sahin ◽  
Metin Ozalay ◽  
Huseyin Demirors ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Rare Complication ◽  
Brain Parenchyma ◽  
Cerebrospinal Fluid Leakage ◽  
Decompression Surgery ◽  
Unusual Complication ◽  
Dural Tear ◽  
Cerebellar Hemorrhage ◽  
Remote Cerebellar Hemorrhage ◽  
Dural Tears

Abstract OBJECTIVE AND IMPORTANCE: This report presents a case in which cerebellar hemorrhage occurred after lumbar decompression surgery that was complicated by dural tear and prolonged cerebrospinal fluid leakage. Remote cerebellar hemorrhage after spinal surgery is extremely rare. Our objective is to describe this unusual complication, discuss the possible mechanisms of remote cerebellar hemorrhage, and review the literature. CLINICAL PRESENTATION: A 73-year-old woman underwent surgery for lumbar spinal stenosis. A dural tear occurred during decompression, and the patient developed remote cerebellar hemorrhage on postoperative Day 2. INTERVENTION: The cerebellar hemorrhage was treated surgically, and a biopsy of hemorrhagic brain parenchyma revealed an arteriovenous malformation. CONCLUSION: Although it is an extremely rare complication, remote cerebellar hemorrhage should be kept in mind as a possible complication of spinal surgery, especially in operations complicated by dural tears.

Cerebrospinal fluid leaks following spinal surgery: use of fat grafts for prevention and repair

2002 ◽  
Vol 96 (2) ◽  
pp. 250-252 ◽  
Author(s):  
Perry Black
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Surgery ◽  
Effective Means ◽  
Fat Graft ◽  
Dural Tear ◽  
Disc Space ◽  
Fat Grafts ◽  
Csf Leakage ◽  
Dural Tears ◽  
Csf Leaks

✓ Cerebrospinal fluid (CSF) leaks are relatively common following spinal surgery. A midline dural tear in the spine is readily repaired by direct application of sutures; however, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author reports his experience with using fat grafts for the prevention or repair of CSF leaks and proposes a technique in which a large sheet of fat, harvested from the patient's subcutaneous layer, is used to cover not only the dural tear(s) but all of the exposed dura and is tucked into the lateral recess. This procedure prevents CSF from seeping around the fat, which may be tacked to the dura with a few sutures. Fibrin glue is spread on the surface of the fat and is further covered with Surgicel or Gelfoam. For ventral dural tears (associated with procedures in which disc material is excised), fat is packed into the disc space to seal off the ventral dural leak. Dural suture lines following spinal intradural exploration are prophylatically protected from CSF leakage in the same manner. With one exception, 27 dural tears noted during 1650 spinal procedures were successfully repaired using this technique. There was one case of postoperative CSF leakage in 140 cases in which intradural exploration for tumor or other lesions was undertaken. Both postoperative CSF leaks were controlled by applying additional skin sutures. The use of a fat graft is recommended as a rapid, effective means of prevention and repair of CSF leaks following spinal surgery.

scholarly journals Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery

2006 ◽  
Vol 65 (2) ◽  
pp. 136-142 ◽  
Author(s):  
Kazutoshi Hida ◽  
Satoshi Yamaguchi ◽  
Toshitaka Seki ◽  
Shunsuke Yano ◽  
Minoru Akino ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Clinical Application ◽  
Spinal Surgery ◽  
Polyglycolic Acid ◽  
Dural Repair ◽  
Polyglycolic Acid Mesh

scholarly journals A Comparative Analytical Study Of Shukra Dosha With Semen Analysis

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Shivanand F Kawane
Keyword(s):  
Comparative Research ◽  
Analytical Study ◽  
Research Study ◽  
Semen Analysis ◽  
Medical Science ◽  
Modern Science ◽  
Point Of View ◽  
Laboratory Examination ◽  
Different Types ◽  
Clinical Conditions

As we know Shukra dhatu is a most essential end product of the rest of all 6 dhatus of sharira. So, an analytical comparative research study has been made on infertility(bandhatva) patients. In this study, we explain tenets of shukra dhatu and different types of shukra doshas according to Acharya Charaka and Sushruta. According to doshas 8 types of Shukra doshas explaind by acharya and 9 types of semen abnormality by modern science. An attempt has been made to correlate these shukra doshas with an abnormality of semen according to modern medical science, on the basis of clinical features, physical appearance, and laboratory examination of semen. For the study 20 patient suffering from any kind of infertility has been selected from O.P.D. of Shalya Tantra department of Arogyashala rugnalaya, Nashik. On observation, the result showed out of 20 patients , 10 patients suffering from vatapittaj, 6 from shukra kshaya, 2 from vataj and 2 from pittaj shukra dosha according to ayurvedic point of view. Simultaneously we correlate it with different clinical conditions of semen and we found Out of 20 patients, 8 suffering from Oligoasthenospermia, 6 from Oligospermia, 2 from Asthenozoospermia, 2 from Tetratazospermia, 2 from Infective semen.  

Cinco Minutos Solamente: Using Interviewer’s Social Capital to Increase Latino Community Survey Response Rates

2017 ◽  
Vol 11 (2) ◽  
pp. 159-171 ◽  
Author(s):  
Phillip J. Granberry ◽  
Maria Idalí Torres ◽  
Philip S. Brenner ◽  
Leandra Smollin ◽  
Jose Saavedra ◽  
...  
Keyword(s):  
Social Capital ◽  
Puerto Rican ◽  
Research Study ◽  
Response Rate ◽  
Research Participation ◽  
Census Bureau ◽  
Household Surveys ◽  
Post Intervention ◽  
Latino Community ◽  
Cultural Affirmation

Declining social capital is one explanation for lower response to household surveys. By intentionally developing an awareness of social capital among its interviewers, the Por Ahí Dicen research study encouraged the use of interviewer social capital as a mechanism to achieve a response rate of 65.2 percent for baseline and post-intervention household studies of Puerto Rican mothers ( n = 413). These surveys were conducted in a “hard-to-count” urban environment designated by the U.S. Census Bureau. The interviewer trainings highlighted three domains of social capital: reciprocity and generalized trust, group or social cohesion, and cultural affirmation. By stressing the importance of social capital as an engagement tool, interviewers more easily made research participation salient and successfully leveraged Puerto Rican mothers’ participation in the community study.

scholarly journals Clinical Outcome of Spine Surgery Complicated by Accidental Dural Tears: Meta-Analysis of the Literature

2020 ◽  
pp. 219256822091487
Author(s):  
Zeiad A. F. Alshameeri ◽  
El-Nasri Ahmed ◽  
Vinay Jasani
Keyword(s):  
Back Pain ◽  
Clinical Outcome ◽  
Spinal Surgery ◽  
Short Form ◽  
Meta Analysis ◽  
Systemic Review ◽  
Time Interval ◽  
Time Intervals ◽  
Dural Tears ◽  
The Impact

Study Design: Systemic review and meta-analysis. Objectives: Several studies have reported the impact of accidental dural tears (DT) on the outcome of spinal surgery, some with conflicting results. Therefore, the aim of this study was to carry out a systemic review and meta-analysis of the literature to establish the overall clinical outcome of spinal surgery following accidental DT. Method: A systemic literature search was carried out. Postoperative improvement in Oswestry Disability Index (ODI), Short-Form 36 survey (SF36), leg pain visual analogue scale (VAS), and back pain VAS were compared between patients with and without DT at different time intervals. Results: Eleven studies were included in this meta-analysis. There was a slightly better improvement in ODI and leg VAS score (standardized mean difference of −0.06, 95% confidence interval [CI] −0.12 to −0.01, and −0.06, 95% CI −0.09 to −0.02, respectively) in patients without DT at 12 months postsurgery, but this effect was not demonstrated at any other time intervals up to 4 years. There were no differences in the overall SF36 (function) score at any time interval or back pain VAS at 12 months. Conclusion: Based on this study, accidental DT did not have an overall significant adverse impact on the short-term clinical outcome of spinal surgery. More studies are needed to address the long-term impact and other outcome measures including other immediate complications of DT.

scholarly journals Influence of application parameters of ultrasonic-assisted bone instruments on the tear force of a substitute material for spinal dura mater

2018 ◽  
Vol 4 (1) ◽  
pp. 611-614
Author(s):  
Marie C. Foelkel ◽  
Vitali Herzog ◽  
Markus Meier ◽  
Michael M. Morlock
Keyword(s):  
Dura Mater ◽  
Spinal Surgery ◽  
Nerve Tissue ◽  
Cnc Machine ◽  
Full Factorial Experiment ◽  
Critical Areas ◽  
Ultrasonic Assisted ◽  
Substitute Material ◽  
Dural Tears ◽  
Full Factorial

AbstractAn ultrasonic-assisted bone instrument can be used for the dissection of bone in spinal surgery. During surgery, the tip of such a bone instrument can touch spinal dura mater. Especially during critical re-operations, high forces can be unintentionally applied on spinal dura mater. To prevent dural tears, the influence of application parameters on the tear force shall be analyzed. Collagen foil is used as a substitute material for spinal dura mater because of its similar mechanical properties and structure. Sponge cloth is placed below collagen foil to imitate cerebrospinal fluid and nerve tissue. A 3-axis CNC-machine is used to automate the movement of the bone instrument. In a full factorial experiment the influence of amplitude, shape of movement and velocity of movement on the tear force is analyzed. Amplitude has the strongest effect because of the increase in input energy. Velocity also has a significant influence, probably because of the strain rate increasing with velocity. Thus, a surgeon should mainly reduce the amplitude and furthermore the velocity of movement to generate higher safety in critical areas.

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