Korean J Spine.  2016 Mar;13(1):24-29. 10.14245/kjs.2016.13.1.24.

The Use Fibrin Sealant after Spinal Intradural Tumor Surgery: Is It Necessary?

• Won YI
• Kim CH
• Chung CK
• Jahng TA
• Park SB

• KMID: 2161838
• DOI: http://doi.org/10.14245/kjs.2016.13.1.24

Abstract

OBJECTIVE
A fibrin sealant is commonly applied after closure of an incidental or intended durotomy to reduce the complications associated with the leakage of cerebrospinal fluid. Routine usage might not be essential after closure of an intended durotomy, which has clear cut-margins. We investigated the efficacy of fibrin sealants for primary intradural spinal cord tumor surgery.
METHODS
A retrospective review was performed for 231 consecutive surgically treated patients with primary intradural spinal cord tumors without extradural extension. Fibrin sealants were not used for 47 patients (group I: age, 51.57±16.75 years) and were applied to 184 patients (group II: age, 48.8±14.7 years). The surgical procedures were identical except for the use of a fibrin sealant after closure of the durotomy. The primary outcome was the occurrence of complications (wound problems, hematoma collection, infection, and neurological deterioration). The covariates were age, sex, body mass index, operation time, pre-/postoperative ambulation, number of laminectomies, and type of tumor.
RESULTS
Schwannoma was the most common pathology (n=134), followed by meningioma (n=35) and ependymoma (n=31). Complications occurred in 13 patients (3 in group I and 10 in group II, p=0.73). The postoperative ambulation status (p<0.01; odds ratio, 28.8; 95% confidence interval, 6.9-120.0) and operation time (p=0.04; cutoff, 229 minutes; sensitivity, 62%; specificity, 72%) were significant factors, whereas the use of a fibrin glue was not (p=0.47).
CONCLUSION
The use of a fibrin sealant might not be essential to reduce complications after surgery for primary spinal intradural tumor.

Keyword

Fibrin tissue adhesive; Spine; Surgical wound infection; Cerebrospinal fluid; Spinal cord neoplasms

MeSH Terms

Body Mass Index
Cerebrospinal Fluid
Ependymoma
Fibrin Tissue Adhesive*
Fibrin*
Hematoma
Humans
Laminectomy
Meningioma
Neurilemmoma
Odds Ratio
Pathology
Retrospective Studies
Sensitivity and Specificity
Spinal Cord Neoplasms
Spine
Surgical Wound Infection
Walking
Fibrin
Fibrin Tissue Adhesive