Abstract
Dural tear is one of the common complications of spinal surgery leading to cerebrospinal fluid leakage followed by serial secondary symptoms. However, little is known about pathological changes of the spinal cord after dural tear. In the present study, we aimed to study the pathological changes in the spinal cord after dural tear with and without autologous fascia repair. Sixty Sprague-Dawley rats were used for dural tear and autologous fascia graft repair models. Three days and 1 week after surgery, the pathological changes in the spinal cord were analyzed by immunohistochemistry, Western blot, enzyme-linked immunosorbent assay and spinal somatosensory evoked potentials test. Neuroinflammation was found in the parenchyma of the spinal cord characterized by gliosis, increased expression of inflammatory factors and infiltration of exogenesis immunocells in the rats without repair, which impaired the sensory conduction function of the spinal cord at the early stage of injury. Repairing with autologous fascia could attenuate neuroinflammation and help to maintain normal sensory conduction function of the spinal cord. Dural tear could cause a series of inflammatory reactions in the spinal cord and further impair its sensory conduction function at the early stage of injury. Repairing with autologous fascia was a necessary and effective way to prevent the neuroinflammation and to maintain the normal function of the spinal cord.
Highlights
Dural tear and cerebrospinal fluid (CSF) leakage are common, even sometimes unavoidable complications of spinal surgery
We aimed to study the pathological changes in the spinal cord after dural tear with and without autologous fascia repair
Neuroinflammation was found in the parenchyma of the spinal cord characterized by gliosis, increased expression of inflammatory factors and infiltration of exogenesis immunocells in the rats without repair, which impaired the sensory conduction function of the spinal cord at the early stage of injury
Summary
Dural tear and cerebrospinal fluid (CSF) leakage are common, even sometimes unavoidable complications of spinal surgery. The incidence of dural tear and CSF leakage in posterior decompression procedures for patients with thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) is 32 % [1], in percutaneous endoscopic lumbar discectomy is 1.1 % [2], in anterior decompression procedures for cervical ossification of the posterior longitudinal ligament (OPLL) ranges from 4.3 to 32 % [3]. Dural tear and CSF leakage can lead to intracranial hypotension headache, CSF pseudocyst, adhesive arachnoiditis, wound infection, and even cerebrospinal meningitis. Some evidences have demonstrated that the risk of postoperative infection, neural damage, or arachnoiditis can be effectively decreased after dural tear is successfully repaired [4]. Dural repair could reduce connective tissue scar and cystic cavity, enhance tissue spare and restore function after acute spinal cord laceration injury in rats [5,6,7]
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Schedule a callMore From: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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