New sealant gel is effective in closing spinal wounds following surgery, study finds
A gel that creates a watertight seal to close surgical wounds provides a significant advance in the treatment of patients following spinal procedures, effectively sealing spinal wounds 100 percent of the time, a national multicenter randomized study led by researchers at UC Davis has found.
The substance, a polyethylene glycol (PEG) hydrogel sealant, plugs miniscule leaks in the thin sheath inside the spinal column that encloses the spinal cord, called the dura. The spinal cord and nerves float in cerebrospinal fluid inside the sheath.
The gel is an important step forward because even pinhole-sized leaks of spinal fluid can lead to another surgery and can expose the surgical wound to bacteria, increasing the risk of serious infection, including meningitis, said the study's lead author, Kee Kim. Kim is an associate professor of neurological surgery at the School of Medicine at UC Davis, chief of spinal neurosurgery and co-director of the UC Davis Spine Center.
"This substance is synthetic so there is no possibility of disease transmission but does not replace a careful surgical technique of closing the dura with the sutures," Kim said. "This sealant allows easy repair of spinal leak that may be present even after best attempts at dural closure with suturing."
The study, published online in the journal Spine, was conducted in 158 patients treated at 24 centers throughout the United States. It examined the effectiveness and safety of the sealant when used as an adjunct to suturing the dura during surgery.
The gel was approved for use in the spine by the Food and Drug Administration late in 2010.
For the study, patients were randomized in the operating room if a spinal fluid leak was seen after the dura was closed with the sutures. One hundred and two of the patients received the PEG hydrogel spinal sealant and 56 received standard care closing the dura with additional sutures and/or fibrin glue. Participants were excluded from the study if they had prior spine surgery or were undergoing chemotherapy, radiation treatment or had other compounding health problems, such as compromised immune systems, uncontrolled diabetes or poor renal functioning.
The researchers determined whether the treatment had achieved a water-tight seal through the use of the "Valsalva maneuver," essentially attempting to expel spinal fluid through the closed dura. The study found that the patients who received the sealant had a significantly higher rate of watertight closure 100 percent versus only 64 percent watertight closure.
The PEG gel is a liquid that quickly solidifies and forms a tight seal when it comes into contact with the body. Other sealants commonly used to create a watertight seal in spinal wounds include fibrin glue, made from other donor blood or animal matter, which is not optimal because it remains in place for only five to seven days and carries a risk of disease transmission, the researchers said.
"This is one of many clinical trials carried out at the UC Davis Spine Center that helps to provide our patients with spinal disorder not only the latest but the best available treatment" Kim said.
Provided by University of California - Davis
- Doctors fix spinal fluid leak with glue May 27, 2007 | not rated yet | 0
- New classification of spinal deformity defines range of normalcy Dec 09, 2008 | not rated yet | 0
- Study finds spine surgery yields greater benefits over nonsurgical treatments Feb 24, 2008 | not rated yet | 0
- Study investigates the cost effectiveness of spinal surgery Dec 29, 2008 | not rated yet | 0
- Researcher finds natural hydrogel helps heal spinal cord Sep 17, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
1 hour ago Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
22 hours ago As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
Every day, their baby stopped breathing, his collapsed bronchus blocking the crucial flow of air to his lungs. April and Bryan Gionfriddo watched helplessly, just praying that somehow the dire predictions ...
Medical research 12 hours ago | 5 / 5 (2) | 0
The human gut is loaded with commensal bacteria – "good" microbes that, among other functions, help the body digest food. The gastrointestinal tract contains literally trillions of such cells, and yet the ...
Medical research 16 hours ago | 5 / 5 (3) | 0 |
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
Medical research 16 hours ago | 4.9 / 5 (7) | 0 |
On May 22, JoVE will publish details of a technique to measure the health of human genetic material in relation to a patient's age. The method is demonstrated by the laboratory of Dr. Gil Atzmon at New York's Albert Einste ...
Medical research 19 hours ago | not rated yet | 0
(Medical Xpress)—Scientists supported by the National Institutes of Health have a new theory as to why a woman's fertility declines after her mid-30s. They also suggest an approach that might help slow ...
Medical research 21 hours ago | not rated yet | 0 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
16 hours ago | 4.7 / 5 (3) | 0 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
13 hours ago | 5 / 5 (2) | 2 |
Existing research shows that bicyclists who wear helmets have an 88 percent lower risk of brain injury, but researchers at Boston Children's Hospital found that simply having bicycle helmet laws in place showed a 20 percent ...
5 hours ago | not rated yet | 0
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
12 hours ago | 4 / 5 (2) | 0 |
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
13 hours ago | not rated yet | 0 |
In a series of lab experiments designed to unravel the workings of a key enzyme widely considered a possible trigger of rheumatoid arthritis, researchers at Johns Hopkins have found that in the most severe ...
15 hours ago | 5 / 5 (1) | 0 |