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The use of a dehydrated amnion/chorion membrane allograft in patients who subsequently undergo reexploration after posterior lumbar instrumentation.

Subach BR, Copay AG - Adv Orthop (2015)

Bottom Line: Conclusions.Our findings suggest that dHACM implant during TLIF may have favorable effects on epidural fibrosis and is well tolerated.Further studies with larger cohorts are required to prove our results.

View Article: PubMed Central - PubMed

Affiliation: Virginia Spine Institute & Spinal Research Foundation, 1831 Wiehle Avenue, Suite 200, Reston, VA 20190, USA.

ABSTRACT
Background Context. Products that can reduce development of epidural fibrosis may reduce risk for ongoing pain associated with development of scar tissue and make subsequent epidural reexploration easier. Purpose. To evaluate the use of dehydrated human amnion/chorion membrane (dHACM) on the formation of soft tissue scarring in the epidural space. Study Design. Case series. Patient Sample. Five patients having transforaminal lumbar interbody lumbar fusion (TLIF) with posterior instrumentation and implantation of dHACM in the epidural space and subsequent epidural reexploration. Outcome Measures. Degree of scar tissue adjacent to the epidural space at reexploration. Intraoperative and postoperative complications related to dHACM and patient reported outcomes. Methods. The degree of scar tissue adjacent to the epidural space was assessed during the reexploration surgery. Patients' outcomes were collected using standard validated questionnaires. Results. Four of 5 cases had easily detachable tissue during epidural reexploration. Angiolipoma of 10% was noted in 1 case and 5% in 2 cases. Significant improvements in patient reported outcomes were observed. No intraoperative or postoperative complications occurred. Conclusions. Our findings suggest that dHACM implant during TLIF may have favorable effects on epidural fibrosis and is well tolerated. Further studies with larger cohorts are required to prove our results.

No MeSH data available.


Related in: MedlinePlus

Sample averages for back pain and leg pain.  Back pain: P = 0.007.
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fig3: Sample averages for back pain and leg pain.  Back pain: P = 0.007.

Mentions: Individual patient outcomes are reported in Table 3 and the averages for the patient sample are reported in Figures 2 and 3. The Oswestry Disability Index (ODI) measures disability; a lower ODI score indicates improvement. Similarly, a lower score on the numerical rating scale for back pain and leg pain indicates a lower pain level. The Physical Component Summary (PCS) and the Mental Component Summary (MCS) of the Medical Outcomes Study Questionnaire Short Form 36 are an indication of physical health and mental health, respectively. A higher score indicates improvement for PCS and MCS. On average, patients show a significant improvement in disability (ODI) and mental well-being (MCS).


The use of a dehydrated amnion/chorion membrane allograft in patients who subsequently undergo reexploration after posterior lumbar instrumentation.

Subach BR, Copay AG - Adv Orthop (2015)

Sample averages for back pain and leg pain.  Back pain: P = 0.007.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4309213&req=5

fig3: Sample averages for back pain and leg pain.  Back pain: P = 0.007.
Mentions: Individual patient outcomes are reported in Table 3 and the averages for the patient sample are reported in Figures 2 and 3. The Oswestry Disability Index (ODI) measures disability; a lower ODI score indicates improvement. Similarly, a lower score on the numerical rating scale for back pain and leg pain indicates a lower pain level. The Physical Component Summary (PCS) and the Mental Component Summary (MCS) of the Medical Outcomes Study Questionnaire Short Form 36 are an indication of physical health and mental health, respectively. A higher score indicates improvement for PCS and MCS. On average, patients show a significant improvement in disability (ODI) and mental well-being (MCS).

Bottom Line: Conclusions.Our findings suggest that dHACM implant during TLIF may have favorable effects on epidural fibrosis and is well tolerated.Further studies with larger cohorts are required to prove our results.

View Article: PubMed Central - PubMed

Affiliation: Virginia Spine Institute & Spinal Research Foundation, 1831 Wiehle Avenue, Suite 200, Reston, VA 20190, USA.

ABSTRACT
Background Context. Products that can reduce development of epidural fibrosis may reduce risk for ongoing pain associated with development of scar tissue and make subsequent epidural reexploration easier. Purpose. To evaluate the use of dehydrated human amnion/chorion membrane (dHACM) on the formation of soft tissue scarring in the epidural space. Study Design. Case series. Patient Sample. Five patients having transforaminal lumbar interbody lumbar fusion (TLIF) with posterior instrumentation and implantation of dHACM in the epidural space and subsequent epidural reexploration. Outcome Measures. Degree of scar tissue adjacent to the epidural space at reexploration. Intraoperative and postoperative complications related to dHACM and patient reported outcomes. Methods. The degree of scar tissue adjacent to the epidural space was assessed during the reexploration surgery. Patients' outcomes were collected using standard validated questionnaires. Results. Four of 5 cases had easily detachable tissue during epidural reexploration. Angiolipoma of 10% was noted in 1 case and 5% in 2 cases. Significant improvements in patient reported outcomes were observed. No intraoperative or postoperative complications occurred. Conclusions. Our findings suggest that dHACM implant during TLIF may have favorable effects on epidural fibrosis and is well tolerated. Further studies with larger cohorts are required to prove our results.

No MeSH data available.


Related in: MedlinePlus