Search Results

You are looking at 1 - 10 of 1,324 items for :

Clear All
Restricted access

James T. Robertson, Albert L. Meric, F. Curtis Dohan Jr., John B. Schweitzer, Jerome R. Wujek and Shafik Ahmad

T he formation of peridural scar tissue is an expected consequence of laminectomy. Cells that generate the fibrosis may include fibroblasts migrating from the adjacent paraspinal musculature. 17 A variety of synthetic and organic materials have been placed in the laminectomy site of experimental animals either to decrease the amount of scarring or to keep the scar from forming dense adhesions to the dura. Silastic, Dacron, methacrylate, bone graft, synthetic membranes and foams, free and pedicle fat grafts, and steroids have been utilized with inconsistent

Restricted access

Postoperative fibrosis after surgical treatment of the porcine spinal cord: a comparison of dural substitutes

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Iftikharul Haq, Yenisel Cruz-Almeida, Edir B. Siqueira, Michael Norenberg, Barth A. Green and Allan D. Levi

T he use of a dural substitute to repair defects within the spinal dura mater or to enlarge the spinal dural sac is not an infrequent requirement in neurosurgery. Some of the more common spinal conditions include Chiari malformations, tethered cord, syringomyelia, and malignant intradural tumors. A postoperative inflammatory reaction followed by fibrosis involving the arachnoid membrane may lead to various complications. When dense adhesions between the spinal cord and the overlying dura mater occur, arachnoiditis, tethering, and neurological deterioration may

Restricted access

Neurosurgical Forum: Letters to the Editor To The Editor Kee D. Kim , M.D. University of California, Davis Sacramento, California 400 401 Abstract Object. The authors of clinical studies have demonstrated a significant association between the presence of extensive post—lumbar discectomy peridural scar formation and the recurrence of low-back and radicular pain. Low-dose perioperative radiotherapy has been demonstrated to inhibit peridural fibrosis after laminectomy in animal models. The present study was

Restricted access

Adnan A. Abla, Joseph C. Maroon, John S. Kennerdell and Ziad L. Deeb

O rbital apex meningiomas are notorious for their recurrence despite all forms of surgical attempts at removal. 1, 3, 8 Recently, we reoperated on a patient with a suspected recurrent meningioma as demonstrated by computerized tomography (CT). Instead of a recurrent tumor, we found a silicone plate, which had been used to repair the orbital roof in a previous craniotomy, and which was now encased in fibrosis. We present this case to alert others to this unusual complication and therapeutic misadventure. Case Report This 38-year-old woman developed

Restricted access

Suat E. Çelik, Tugrul. Altan, Sevinç Çelik, Kamber Göksu, İrfan İnce and Ziya Kapran

F ailed – back surgery syndrome is a significant adverse event occurring after lumbar disc surgery for treatment of recurrent radiculopathy and sciatica. Despite the improvements in surgical microtechniques and neuroradiological refinements, peridural fibrosis remains a principal unsolved problem in up to 24% of cases of failed–back surgery syndrome. 6 , 22 Peridural fibrosis challenges the surgeon in 2 ways. First, it is difficult to expose the same surgical field in a second operation because of adhesions, and there is an increased risk of dural tearing

Restricted access

Evaluation of DuraGen in preventing peridural fibrosis in rabbits

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2005

Claudio E. Tatsui, Gonzalo Martinez, Xiuming Li, Pradip Pattany and Allan D. Levi

of the scar tissue is related to the extent of the laminectomy, 23 and it has been postulated that the fibrosis can cause dural sac and nerve root tethering and compression which restricts their mobility and causes pain due to local nerve fiber traction. 28 An association between the extent of MR imaging–visualized postoperative epidural scar and recurrent radicular pain has been reported; 39 the reduction of peridural scar formation has been shown to be associated with better clinical results after lumbar discectomy. 7 Failed–back surgery syndrome is

Restricted access

Neurosurgical Forum: Letters to the editor To The Editor Michael Scott , M.D. Philadelphia, Pennsylvania 274 275 Intractable back and/or sciatic pain after multiple laminectomies for intervertebral disc protrusions is often attributed to an “adhesive subarachnoid fibrosis.” Many procedures such as rhizotomy, facet rhizotomy, cordotomy, dorsal column stimulation, and even acupuncture have been tried with varying success to treat the pain attributed to the “fibrosis.” If adhesive subarachnoid fibrosis is an

Restricted access

Neurosurgical Forum: Letters to the editor To The Editor Damianos E. Sakas , M.D. , Anthony E. Booth , F.R.C.S. Walsgrave General Hospital Coventry, England 1130 1131 We read with great interest the paper by Robertson, et al. , on the potential of the semisynthetic compound GT1587 in preventing peridural fibrosis (Robertson JT, Meric AL, Dohan FC Jr, et al: The reduction of postlaminectomy peridural fibrosis in rabbits by a carbohydrate polymer. J Neurosurg 79: 89–95, July, 1993). The results of the

Restricted access

Fikret Dogulu, Gokhan Kurt, Hakan Emmez, Ozlem Erdem, Leyla Memis, Kemali Baykaner and Necdet Ceviker

P ostlaminectomy peridural fibrosis, which causes symptom recurrence due to compression or tethering of the nerve roots, is a well-known complication of lumbar disc surgery. Although creation of a small surgical wound, meticulous technique to minimize tissue damage, and good hemostasis are the most accepted measures to avoid this devastating complication, symptomatic peridural fibrosis may nonetheless develop in many cases. A variety of biological and nonbiological materials have been studied to prevent peridural fibrosis in animal models. 1–3, 5, 6, 8

Restricted access

Berker Cemil, Kagan Tun, Erkan Kaptanoglu, Figen Kaymaz, Banu Cevirgen, Ayhan Comert and Ibrahim Tekdemir

P ostlaminectomy epidural fibrosis, the formation of a dense scar tissue adjacent to the dura mater following posterior lumbar surgery, characterizes the normal response of the body to surgery. 8 The mechanical tethering of nerve roots or the dura by the epidural adhesions may be a contributing factor for a significant subset of patients suffering from persistent back and leg pain following lumbar laminectomy, the so-called “failed back syndrome.” 34 Failed back syndrome is a source of difficulty in the daily activities of patients, 14 and reoperation for