Acta Neurochirurgica

, Volume 153, Issue 1, pp 142–147 | Cite as

Use of a collagen biomatrix (TissuDura®) for dura repair: a long-term neuroradiological and neuropathological evaluation

  • Ciro Parlato
  • Giuseppe di Nuzzo
  • Marianna Luongo
  • Raffaele Stefano Parlato
  • Marina Accardo
  • Luigi Cuccurullo
  • Aldo Moraci
Clinical Article

Abstract

Purpose

The aim of this study was to evaluate the clinical, neuroradiological, and neuropathological outcomes of patients treated with equine collagen foil (TissuDura®) as a dura mater substitute during cranial and spinal neurosurgical procedures.

Materials and Methods

All patients treated at the Department of Neurosurgery of the Second University of Naples with TissuDura between 2005 and 2009 were included. Dural reconstruction was performed using TissuDura, overlaid 1 cm over the dural defect with additional fixation using fibrin glue. No surgical sutures were used. Patients underwent postoperative contrast-enhanced magnetic resonance scans at 1 week, 1 month, and 1 year after surgery to detect any cerebrospinal fluid (CSF) leaks, infections, inflammations, or CSF circulation in the surgical region.

Results

Dural reconstruction was performed in 74 patients, including 50 patients with tumors, two with C2 neurinoma, two with acoustic neurinoma, six with Chiari I malformation, two with severe head injury, and 12 requiring spinal surgery. Clinical and neuroradiological findings were normal and no signs of graft rejection or CSF leaks at postoperative follow-up were observed. In two cases of atypical meningioma, re-operation of the dural reconstruction was performed after 1 year. No adherences between brain and neodura were detected, and histopathological investigations demonstrated dural regeneration.

Conclusions

Following dural reconstructions with TissuDura without surgical sutures, no local toxicity or complications were observed for up to 1 year. TissuDura demonstrated elasticity, non-reactivity, and good adaptability. The overlay technique using fibrin glue was simple and fast. Future studies and longer follow-up are needed to confirm the efficacy of TissuDura.

Keywords

Dural repair Dural substitute Collagen biomatrix TissuDura 

Notes

Acknowledgements

Editorial assistance was provided by Alpha-Plus Medical Communications Ltd (UK).

Disclosures/conflicts of interest

Patients gave consent for treatment and use of figures and cases. None of the authors has any financial interest in the materials and methods used, nor in any of the manufacturers mentioned in this report.

Financial support for the production of this manuscript was provided by Baxter BioSurgery, Italy.

Supplementary material

701_2010_718_MOESM1_ESM.mpg (14.6 mb)
Video 1 Dural reconstruction in cerebellopontine angle surgery after removal of acoustic neurinoma (MPG 14942 kb)

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Ciro Parlato
    • 1
    • 3
  • Giuseppe di Nuzzo
    • 1
  • Marianna Luongo
    • 1
  • Raffaele Stefano Parlato
    • 1
  • Marina Accardo
    • 2
  • Luigi Cuccurullo
    • 2
  • Aldo Moraci
    • 1
  1. 1.Department of NeurosurgerySecond University of NaplesNaplesItaly
  2. 2.Department of Public Health, Section of PathologySecond University of NaplesNaplesItaly
  3. 3.NaplesItaly

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