Introduction: Establishing a watertight barrier after breaching the dura is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks.
Methods: Using canine cranial and lumbar durotomy repair models, we evaluated a next generation polyethylene glycol (PEG)-based hydrogel in augmenting standard methods of dural repair.
Results: The hydrogel is readily visible on T2 MRI sequences and shows a delayed degradation profile on serial imaging. There were no CSF leaks noted at the cranial durotomy repair sites treated with the novel hydrogel even at supra physiologic intracranial pressures. However, CSF leaks were noted in all control cranial durotomy repair animals. Similarly, in the hydrogel-treated group, no CSF leaks were noted in the lumbar durotomy repair sites; evidence of CSF leaks was present in all the controls. No difference in immune infiltrates was observed between test sealant groups and their respective controls. Finally, extent of dural adhesions and peridural fibrosis was limited in the hydrogel treated animals compared with controls.
Conclusions: Our analysis confirmed the novel PEG-based hydrogel sealant to be safe and effective in maintaining a watertight dura seal in canine cranial and lumbar durotomy repair models.
Patient Care: Decrease the incidence of CSF leaks and their subsequent complications.
Learning Objectives: By the conclusion of this session, participants should be able to 1) describe the importance of achieving a watertight dural closure 2) identify potential complications associated with other dural repair products and 3) discuss the advantages of this novel hydrogel sealant in achieving and maintaining a watertight dura seal in a canine durotomy repair model.