Abstract
Background/aimThe management of dura-related complications, such as the repairment of dural tears and reconstruction of large dural defects, remain the most challenging subjects of neurosurgery. Numerous surgical techniques and synthetic or autologous adjuvant materials have emerged as an adjunct to primary dural closure, which may result in further complications or side effects. Therefore, the subcutaneous autologous free adipose tissue graft has been recommended for the protection of the central nervous system and repairment of the meninges. In addition, human adipose tissue is also a source of multipotent stem cells. However, epidural adipose tissue seems more promising than subcutaneous because of the close location and intercellular communication with the spinal cord. Herein, it was aimed to define differentiation capability of both subcutaneous and epidural adipose tissue-derived stem cells (ASCs).Materials and methodsHuman subcutaneous and epidural adipose tissue specimens were harvested from the primary incisional site and the lumbar epidural space during lumbar spinal surgery, and ASCs were isolated.ResultsThe results indicated that both types of ASCs expressed the cell surface markers, which are commonly expressed stem cells; however, epidural ASCs showed lower expression of CD90 than the subcutaneous ASCs. Moreover, it was demonstrated that the osteogenic and neurogenic differentiation capability of epidural adipose tissue-derived ASCs was more pronounced than that of the subcutaneous ASCs.ConclusionConsequently, the impact of characterization of epidural ASCs will allow for a new understanding for dural as well as central nervous system healing and recovery after an injury.
Highlights
Despite the long history of spinal surgery, a primary watertight dural closure is still one of the most challenging subjects in neurosurgery
Materials and methods: Human subcutaneous and epidural adipose tissue specimens were harvested from the primary incisional site and the lumbar epidural space during lumbar spinal surgery, and adipose tissue-derived stem cells (ASCs) were isolated
The results indicated that both types of ASCs expressed the cell surface markers, which are commonly expressed stem cells; epidural ASCs showed lower expression of cluster differentiation 90 (CD90) than the subcutaneous ASCs
Summary
Despite the long history of spinal surgery, a primary watertight dural closure is still one of the most challenging subjects in neurosurgery. The treatment of leakage often requires extended postoperative hospitalization, placement of subarachnoid drainage, and surgical revision. These processes may frequently lead to further complications, such as deep vein thrombosis, pulmonary embolism, pneumonia, urinary tract infection, subdural or cerebellar hematomas, as well as increased medical expenses [1]. The mechanisms of tissue repair or tissue healing after an injury is complex with dynamic responses. The types of tissues, severity of injury, and immune response are closely related in these processes. Recent studies have revealed that endogenous stem cells play a critical role in tissue healing with both complete
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