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 (PEG) hydrogel sealant, plugs miniscule leaks in the thin sheath inside the 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 at the School of Medicine at UC Davis, chief of spinal and co-director of the UC Davis Spine Center.

"This substance is synthetic so there is no possibility of 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 late in 2010.

For the study, patients were randomized in the 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 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

not rated yet

Related Stories

Study investigates the cost effectiveness of spinal surgery

Dec 29, 2008

Back pain affects more than 80 percent of people and costs more than $100 billion annually in the U.S. But is the surgery cost effective? A study by researchers at Rush University Medical Center suggests that for patients ...

Researcher finds natural hydrogel helps heal spinal cord

Sep 17, 2009

Research led by a scientist at the Barrow Neurological Institute at St. Joseph's Hospital and Medical Center has shown injecting biomaterial gel into a spinal cord injury site provides significantly improved healing. The ...

Recommended for you

Team untangles the biological effects of blue light

15 hours ago

Blue light can both set the mood and set in motion important biological responses. Researchers at the University of Pennsylvania's School of Medicine and School of Arts and Sciences have teased apart the ...

User comments