nach oben

Erschienen in:

01.06.2018 | Original Article - Pediatric Neurosurgery

Homologous cryopreserved amniotic membrane in the repair of myelomeningocele: preliminary experience

verfasst von: Elisabetta Marton, Enrico Giordan, Giorgio Gioffrè, Giuseppe Canova, Adolfo Paolin, Marina Grazia Mazzucco, Pierluigi Longatti

Erschienen in: Acta Neurochirurgica | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Objective

Surgical management of spinal dysraphism often requires the use of dural substitutes. Amniotic membrane (AM) has drawn the interest of clinicians for its valuable concentration of cytokines and factors capable of promoting wound healing, re-epithelialization, inhibiting fibrosis and regulating angiogenesis. These beneficial qualities could make AM an interesting dural substitute for spina bifida repair. In this study, we describe the use of banked homologous AM as a dural substitute for the repair of spinal dysraphism in newborns. Our purpose is to test the mechanical characteristics, as well as the safety and effectiveness of AM in preventing postoperative complications and re-tethering.

Methods

The AM patch was carefully detached from the chorion of donors undergoing caesarean section, rinsed in saline solution, and cryopreserved in liquid nitrogen. Five newborns were treated using AM: three affected by open spinal dysraphism and two by spina bifida occulta. The AM patch was used as a dural substitute with two different positions and purposes: the amnion-side down covering the placode to prevent adhesions or placed extradurally facing the dura to avoid scarring and facilitating the sliding of the dural sac itself under the extradural tissue layers.

Results

No adverse events occurred, and the surgical wounds healed without complications. MRI scans taken at 3 and 6 months after surgery showed a satisfying de-tethering of the spinal cord with no obvious evidence of new adherence formation.

Conclusions

We present a multimodal interposition technique using AM as a reconstructive and anti-adhesive tissue for the treatment of open myelomeningocele (MMC) and lipomeningocele (LMC) treatment. In our experience, AM proved its efficacy in restoring the dural sac integrity without complications. We support the use of AM as a promising dural substitute, speculating on how the use of AM could potentially change reconstructive strategies for spinal dysraphism.

dR A (1940) Plastic repair of conjunctival defects with fetal membrane. Arch Ophthalmol 23:522–525CrossRef

Adzick NS, Thom EA, Spong CY, Brock JW 3rd, Burrows PK, Johnson MP, Howell LJ, Farrell JA, Dabrowiak ME, Sutton LN, Gupta N, Tulipan NB, D'Alton ME, Farmer DL (2011) A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 364:993–1004. https://doi.org/10.1056/NEJMoa1014379 CrossRefPubMedPubMedCentral

Branski LK, Herndon DN, Celis MM, Norbury WB, Masters OE, Jeschke MG (2008) Amnion in the treatment of pediatric partial-thickness facial burns. Burns 34:393–399. https://doi.org/10.1016/j.burns.2007.06.007 CrossRefPubMed

Brown EG, Saadai P, Pivetti CD, Beattie MS, Bresnahan JC, Wang A, Farmer DL (2014) In utero repair of myelomeningocele with autologous amniotic membrane in the fetal lamb model. J Pediatr Surg 49:133–137; discussion 137-138. https://doi.org/10.1016/j.jpedsurg.2013.09.043 CrossRefPubMed

Carvalho NS, Moron AF, Menon R, Cavalheiro S, Barbosa MM, Milani HJ, Ishigai MM (2017) Histological evidence of reparative activity in chorioamniotic membrane following open fetal surgery for myelomeningocele. Exp Ther Med 14:3732–3736. https://doi.org/10.3892/etm.2017.4976 CrossRefPubMedPubMedCentral

de Weerd L, Weum S, Sjavik K, Acharya G, Hennig RO (2013) A new approach in the repair of a myelomeningocele using amnion and a sensate perforator flap. J Plast Reconstr Aesthet Surg : JPRAS 66:860–863. https://doi.org/10.1016/j.bjps.2012.11.020 CrossRefPubMed

Gajiwala K, Lobo Gajiwala A (2003) Use of banked tissue in plastic surgery. Cell Tissue Bank 4:141–146. https://doi.org/10.1023/B:CATB.0000007023.85139.c5 CrossRefPubMed

Grivell RM, Andersen C, Dodd JM (2014) Prenatal versus postnatal repair procedures for spina bifida for improving infant and maternal outcomes. Cochrane Database Syst Rev : Cd008825. doi: https://doi.org/10.1002/14651858.CD008825.pub2

Gurer B, Kertmen H, Akturk UD, Kalan M, Sekerci Z (2014) Use of the bovine pericardial patch and fibrin sealant in meningomyelocele closure. Acta Neurochir 156:1345–1350. https://doi.org/10.1007/s00701-014-2099-4 CrossRefPubMed

10.

Hasegawa M, Fujisawa H, Hayashi Y, Yamashita J (2004) Autologous amnion graft for repair of myelomeningocele: technical note and clinical implication. J Clin Neurosci : Off J Neurosurg Soc Aust 11:408–411. https://doi.org/10.1016/j.jocn.2003.11.006 CrossRef

11.

Insausti CL, Alcaraz A, Garcia-Vizcaino EM, Mrowiec A, Lopez-Martinez MC, Blanquer M, Pinero A, Majado MJ, Moraleda JM, Castellanos G, Nicolas FJ (2010) Amniotic membrane induces epithelialization in massive posttraumatic wounds. Wound Repair Regen 18:368–377. https://doi.org/10.1111/j.1524-475X.2010.00604.x CrossRefPubMed

12.

Koizumi NJ, Inatomi TJ, Sotozono CJ, Fullwood NJ, Quantock AJ, Kinoshita S (2000) Growth factor mRNA and protein in preserved human amniotic membrane. Curr Eye Res 20:173–177CrossRefPubMed

13.

Lien SC, Maher CO, Garton HJ, Kasten SJ, Muraszko KM, Buchman SR (2010) Local and regional flap closure in myelomeningocele repair: a 15-year review. Childs Nerv Syst 26:1091–1095. https://doi.org/10.1007/s00381-010-1099-9 CrossRefPubMed

14.

Liu J, Sheha H, Fu Y, Liang L, Tseng SC (2010) Update on amniotic membrane transplantation. Expert Rev Ophthalmol 5:645–661. https://doi.org/10.1586/eop.10.63 CrossRefPubMedPubMedCentral

15.

Mamede AC, Carvalho MJ, Abrantes AM, Laranjo M, Maia CJ, Botelho MF (2012) Amniotic membrane: from structure and functions to clinical applications. Cell Tissue Res 349:447–458. https://doi.org/10.1007/s00441-012-1424-6 CrossRefPubMed

16.

Ozcelik D, Yildiz KH, Is M, Dosoglu M (2005) Soft tissue closure and plastic surgical aspects of large dorsal myelomeningocele defects (review of techniques). Neurosurg Rev 28:218–225. https://doi.org/10.1007/s10143-004-0357-2 CrossRefPubMed

17.

Paolin A, Trojan D, Leonardi A, Mellone S, Volpe A, Orlandi A, Cogliati E (2016) Cytokine expression and ultrastructural alterations in fresh-frozen, freeze-dried and gamma-irradiated human amniotic membranes. Cell Tissue Bank 17:399–406. https://doi.org/10.1007/s10561-016-9553-x CrossRefPubMedPubMedCentral

18.

Patel KB, Taghinia AH, Proctor MR, Warf BC, Greene AK (2012) Extradural myelomeningocele reconstruction using local turnover fascial flaps and midline linear skin closure. J Plast Reconstr Aesthet Surg 65:1569–1572. https://doi.org/10.1016/j.bjps.2012.03.029 CrossRefPubMed

19.

Pedreira DA, Zanon N, Nishikuni K, Moreira de Sa RA, Acacio GL, Chmait RH, Kontopoulos EV, Quintero RA (2016) Endoscopic surgery for the antenatal treatment of myelomeningocele: the CECAM trial. Am J Obstet Gynecol 214:111.e111. https://doi.org/10.1016/j.ajog.2015.09.065 CrossRef

20.

Saad H, Krisht KM, Yang WH, Lopez-Gonzalez MA, Aboud E, Krisht AF (2017) Biocompatible amniotic sac implant maintains a scar-free brain surface during recurrent glioma surgery. World Neurosurg 107:308–313. https://doi.org/10.1016/j.wneu.2017.07.143 CrossRefPubMed

21.

Solomon A, Pires RT, Tseng SC (2001) Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia. Ophthalmology 108:449–460CrossRefPubMed

22.

Sridhar MS, Bansal AK, Sangwan VS, Rao GN (2000) Amniotic membrane transplantation in acute chemical and thermal injury. Am J Ophthalmol 130:134–137CrossRefPubMed

23.

Tao H, Fan H (2009) Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions. Eur Spine J 18:1202–1212. https://doi.org/10.1007/s00586-009-1013-x CrossRefPubMedPubMedCentral

24.

Tomita T, Hayashi N, Okabe M, Yoshida T, Hamada H, Endo S, Nikaido T (2012) New dried human amniotic membrane is useful as a substitute for dural repair after skull base surgery. J Neurol Surg B Skull Base 73:302–307. https://doi.org/10.1055/s-0032-1321506 CrossRefPubMedPubMedCentral

25.

Tseng SC, Espana EM, Kawakita T, Di Pascuale MA, Li W, He H, Liu TS, Cho TH, Gao YY, Yeh LK, Liu CY (2004) How does amniotic membrane work? Ocul Surf 2:177–187CrossRefPubMed

26.

Tulipan N, Wellons JC 3rd, Thom EA, Gupta N, Sutton LN, Burrows PK, Farmer D, Walsh W, Johnson MP, Rand L, Tolivaisa S, D'Alton ME, Adzick NS (2015) Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement. J Neurosurg Pediatr 16:613–620. https://doi.org/10.3171/2015.7.peds15336 CrossRefPubMedPubMedCentral

27.

Turchan A, Rochman TF, Ibrahim A, Fauziah D, Wahyuhadi J, Parenrengi MA, Fauzi AA, Sufarnap E, Bajamal AH, Ferdiansyah SH, Purwati RFA, Paramadini AW, Lumenta CB (2018) Duraplasty using amniotic membrane versus temporal muscle fascia: a clinical comparative study. J Clin Neurosci 50:272–276. https://doi.org/10.1016/j.jocn.2018.01.069 CrossRefPubMed

28.

Walker CT, Godzik J, Kakarla UK, Turner JD, Whiting AC, Nakaji P (2018) Human amniotic membrane for the prevention of intradural spinal cord adhesions: retrospective review of its novel use in a case series of 14 patients. Neurosurgery. https://doi.org/10.1093/neuros/nyx608

29.

Zohar Y, Talmi YP, Finkelstein Y, Shvili Y, Sadov R, Laurian N (1987) Use of human amniotic membrane in otolaryngologic practice. Laryngoscope 97:978–980PubMed

Titel: Homologous cryopreserved amniotic membrane in the repair of myelomeningocele: preliminary experience
verfasst von: Elisabetta Marton
Enrico Giordan
Giorgio Gioffrè
Giuseppe Canova
Adolfo Paolin
Marina Grazia Mazzucco
Pierluigi Longatti
Publikationsdatum: 01.06.2018
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 8/2018
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-018-3577-x

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

25.04.2024 | Hypotonie | Nachrichten

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Homologous cryopreserved amniotic membrane in the repair of myelomeningocele: preliminary experience

Abstract

Objective

Methods

Results

Conclusions

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Demenzkranke durch Antipsychotika vielfach gefährdet

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Update Neurologie

Springer Medizin

Abstract

Objective

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2018

Letter to the editor of Acta Neurochirurgica: Endplate changes after lumbar discectomy with and without implantation of an annular closure device

Non-operative meningiomas: long-term follow-up of 136 patients

Knut Wester (ed.): Arachnoid cysts

Cluster analysis describes constellations of cardiac anomalies presenting in spinal anomaly patients

Reply to letter: Endoscopic transpalpebral transorbital anterior petrosectomy: does safer surgical freedoms necessitates modifications?

Bilateral persistent ‘second’ intersegmental vertebral arteries: illustrated with a case

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Demenzkranke durch Antipsychotika vielfach gefährdet

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Update Neurologie