Rp. Aliredjo et al., The use of Gore-Tex membrane for adhesion prevention in tethered spinal cord surgery: Technical case reports, NEUROSURGER, 44(3), 1999, pp. 674-677
OBJECTIVE: The incidence of retethering caused by postoperative adhesions a
t the repair site after initial tethered spinal cord surgery is not uncommo
n. To assess the effectiveness of a Core-Tex membrane in preventing these a
dhesions, only clinical radiological and experimental animal evaluation has
been reported. In this report, we describe two cases in which Gore-Tex mem
brane was implanted at the initial untethering surgery and in which we were
able to confirm the real effectiveness of the Gore-Tex membrane during a s
econd operation.
METHODS: In the first patient, Gore-Tex membrane was used for dural repair
in the untethering surgery of the split spinal cord malformation. Because o
f the suspicion of a thickened filum terminale, repeated surgery was indica
ted 10 months after the initial procedure. In the second patient, Gore-Tex
membrane was implanted during the initial untethering surgery for a lipo-my
eloschisis and a dermal sinus. Because of a persistent fistula of the derma
l sinus, a second operation was necessary 1 year after the first operation.
RESULTS: During the repeated surgery, a thorough inspection of the implante
d Core-Tex membrane revealed no adhesions between the Gore-Tex membrane and
the intradural content in both cases.
CONCLUSION: We support the use of Core-Tex membrane in the prevention of po
stoperative dural adhesions in the repair of spinal dysraphism.