Repair of Postoperative Cervical Pseudomeningocele with the Use of Bone Morphogenetic Protein
| Autor: | Teck M Soo, Dejan Slavnic, Robert W McCabe, Doris Tong |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Leak
medicine.medical_specialty Nerve root business.industry General Engineering 030204 cardiovascular system & hematology Schwannoma medicine.disease Bone morphogenetic protein Surgery Pseudomeningocele 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Lumbar Medicine Neoplasm business 030217 neurology & neurosurgery |
| Zdroj: | Cureus. |
| ISSN: | 2168-8184 |
| Popis: | Recurrent cerebrospinal fluid (CSF) leak carries significant morbidity and mortality. A 25-year-old Caucasian male developed a symptomatic pseudomeningocele eight days after surgical resection of a cervical schwannoma. With no improvement after lumbar drain placement, the dural sleeve defect over the left C3 nerve root was repaired with suturable DuraGen® (Integra LifeSciences, Plainsboro, NJ, USA). Muscle and fat graft were then laid over the repair site and covered by Tisseel® (Baxter Healthcare, Deerfield, IL, USA). Recombinant human bone morphogenetic protein-2 (rhBMP-2) was applied via extra-small sponge laid over the graft. At 15-month clinical and 16-month radiographic follow-up, the patient had complete resolution of symptoms without any evidence of infection, ectopic bone formation, excessive inflammation, neoplasm, or recurrent CSF leak. This case demonstrates the successful use of BMP in the treatment of recurrent symptomatic cervical pseudomeningocele after tumor resection. We believe that the pro-inflammatory effects of rhBMP-2 lead to early scarring of dural defect and resolution of CSF leak. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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