Effectiveness of the silicone net in the repair of the dura mater in rats subjected to experimental injury

• Grant number: 12/05811-4
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2013
• End date: February 28, 2014
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Luciano Miller Reis Rodrigues
• Grantee: Luciano Miller Reis Rodrigues
• Host Institution: Faculdade de Medicina do ABC (FMABC). Organização Social de Saúde. Fundação do ABC. Santo André , SP, Brazil

Abstract

The accidental dura-mater injury, in lumbar spine surgeries, is one of the most common complications, with a prevalence of 1 to 17%. The increase of lumbar laminectomies in the intervertebral disc disease is the most frequent cause of dural injury in the United States, usually occurring in the ligamentum flavum opening. The sequelae of the injury of the dura-mater have high economic and social costs. the most frequent are: fistulas, arachnoiditis, meningitis, meningeal psudocyst and entrapment of the nerve root in persistent lesions. In surgical repair of dura-mater defects, especially in cases of meningomyelocele, the prevention of postoperative adhesions is an important aspect. Currently, many materials have been used in the repair of dural lesion, including autologous fat, fascia lata, lyophilized dura-mater and synthetic materials. Autologous tissues lead to minimal inflammatory response. However, this alternative may not be the ideal material for all kinds of dural lesion repair. Studies of dural substitutes have involved the cranial side of the spinal cord, and experimental studies on spinal duroplastia are few. The surgical implantation of silicone is udes in various medical specialties such as vascular surgery, urology and plastic surgery. The success of silicone is due to its biological inertia, which is proven in its use as breast implants, implants for long-term drug use (Port-a-Cath®) and penile prostheses. It is ver difficult to compare different types of dural lesion treatments, since there are few previous studies, which are based on a small number of patients. The present study aims to evaluate the effectiveness of the dural lesion repair, with the use of a silicone net through histopathological analysis. Its relevance is due to the lack of consensus in the international literature on methods of repair and new materials that are emerging for treatment and the lack of experimental studies available that can confirm the best method. (AU)