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【文摘发布】在颅脑和脊髓外科应用胶原基质进
imaging study.
Author：Narotam PK, Reddy K, Fewer D, Qiao F, Nathoo N.
Resource: J Neurosurg. 2007 Jan;106(1):45-51.
Abstract：OBJECT: The repair of dural defects is controversial in contemporary
neurosurgery. To date, collagen-based products remain a continued area of
interest in the development of dural grafts. The authors conducted a prospective
case-control study in which they evaluated collagen matrix in the repair of
dural defects following cranial and spinal surgery by using specific clinical
and magnetic resonance (MR) imaging outcome measures. METHODS: Enrolled in the
study were 79 patients, 36 male (45.6%) and 43 female (54.4%), with a mean age
of 53 +/- 15.8 years. The pathological diagnosis was brain tumor in 49 cases
(62%), vascular conditions in 16 (20.2%), degenerative spine in 10 (12.7%),
trauma in two (2.5%), and other in two (2.5%). Most of the patients underwent
supratentorial craniotomy (57; 72.2%), whereas 11 patients (13.9%) each
underwent posterior fossa and spinal surgery. Sixty-three patients (79.7%)
completed the study, which included clinical and MR imaging evaluations at 3
months postsurgery. There were no cerebrospinal fluid (CSF) leaks or delayed
hemorrhages. The neurosurgical wound infection rate was 3.8%: superficial wound
infection in two cases and deep infection and brain abscess in one case
(recurrent brain tumor following radiation therapy). Among the 63 patients in
whom 3-month postsurgery imaging data were available, asymptomatic small
pseudomeningoceles were detected on MR imaging in two (3.2%); a minor subgaleal
fluid collection, which resolved spontaneously, was apparent in another patient
(1.6%). Nonspecific dural enhancement was demonstrated on images obtained in
seven patients (11.1%), and asymptomatic spinal epidural enhancement was
observed on images obtained in two of three patients who had undergone lumbar
laminectomy for spinal stenosis. CONCLUSIONS: When used as a dural onlay graft,
collagen matrix had a 100% CSF containment rate but might be associated with
occult radiological abnormalities.
PMID: 17236486 Title：Collagen matrix duraplasty for cranial and spinal surgery: a clinical and
imaging study.
题目：在颅脑和脊髓手术中应用胶原基质进行硬脑膜成形：一项临床与影像学研究
Author：Narotam PK, Reddy K, Fewer D, Qiao F, Nathoo N.
Resource: J Neurosurg. 2007 Jan;106(1):45-51.
Abstract：
OBJECT: The repair of dural defects is controversial in contemporary neurosurgery. To date, collagen-based products remain a continued area of interest in the development of dural grafts. The authors conducted a prospective case-control study in which they evaluated collagen matrix in the repair of dural defects following cranial and spinal surgery by using specific clinical and magnetic resonance (MR) imaging outcome measures.
目的：在当代神经外科中硬脑（脊）膜的修复有争议。至今，以胶原基质为基础的制品仍是开发硬脑膜修复材料持久的热门领域。在进行一项前瞻性病例对照研究中，作者通过应用特定临床和磁共振成像检查结果评估颅脑和脊髓术后胶原基质材料修复硬脑（脊）膜的疗效。
METHODS: Enrolled in the study were 79 patients, 36 male (45.6%) and 43 female (54.4%), with a mean age of 53 +/- 15.8 years. The pathological diagnosis was brain tumor in 49 cases (62%), vascular conditions in 16 (20.2%), degenerative spine in 10 (12.7%),trauma in two (2.5%), and other in two (2.5%). Most of the patients underwent supratentorial craniotomy (57; 72.2%), whereas 11 patients (13.9%) each underwent posterior fossa and spinal surgery. Sixty-three patients (79.7%) completed the study, which included clinical and MR imaging evaluations at 3 months postsurgery. There were no cerebrospinal fluid (CSF) leaks or delayed hemorrhages. The neurosurgical wound infection rate was 3.8%: superficial wound infection in two cases and deep infection and brain abscess in one case (recurrent brain tumor following radiation therapy). Among the 63 patients in whom 3-month postsurgery imaging data were available, asymptomatic small pseudomeningoceles were detected on MR imaging in two (3.2%); a minor subgaleal fluid collection, which resolved spontaneously, was apparent in another patient (1.6%). Nonspecific dural enhancement was demonstrated on images obtained in seven patients (11.1%), and asymptomatic spinal epidural enhancement was observed on images obtained in two of three patients who had undergone lumbar laminectomy for spinal stenosis.
方法：参与研究的79例患者中，36例男性(45.6%)、43例女性(54.4%)，平均年龄 53 +/- 15.8岁。病理诊断：脑肿瘤49例 (62%)、血管疾病16例 (20.2%)、脊椎退行性变10例(12.7%)、外伤2例 (2.5%、其他2例(2.5%)。患者中57例(72.2%)行幕上开颅术、11例(13.9%)行颅后窝和脊柱手术。63例(79.7%)完成了研究，参与了术后3月的临床和磁共振评估。未出现脑脊液漏或延迟性出血。颅脑手术后感染率为3.8%：2例切口感染，1例放疗后复发的脑肿瘤患者发生深部感染和脑脓肿。63例患者术后3月成像时间均是明确的，磁共振检查发现2例(3.2%)无症状患者小的假性脊膜膨出、1例（1.6%）明显的较少的帽状键膜下积液（通过自动吸收）。所获得的MRI中7例(11.1%)患者出现非特异的硬脑膜增强、行腰椎椎弓切除手术的椎管狭窄患者中2/3观察到无症状脊髓硬膜外增强。
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作者:admin@医学,生命科学 2010-12-22 17:11
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