Histological and biomechanical study of dura mater applied to the technique of dura splitting decompression in Chiari type I malformation

Chauvet, Dorian; Carpentier, Alexandre; Allain, Jean-Marc; Polivka, Marc; Crépin, Jérôme; George, Bernard

doi:10.1007/s10143-010-0261-x

Cited by 45 publications

(35 citation statements)

References 46 publications

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“…The Young's modulus of the outer hydrogel layer and the inner polychloroprene layer is in the same range as the modulus of the protective tissues of the central and peripheral nervous system, namely dura and pia matter (20 MPa and 2.3 MPa, respectively), as well as the nerves itself (elastic modulus of the sciatic nerve is about 40 MPa). [35][36][37] This renders our microchannels mechanically biocompatible for in vivo applications.…”

Section: Doi: 101002/adma201503696mentioning

confidence: 99%

Biomimetic Microelectronics for Regenerative Neuronal Cuff Implants

et al. 2015

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Section: Doi: 101002/adma201503696mentioning

confidence: 99%

Biomimetic Microelectronics for Regenerative Neuronal Cuff Implants

et al. 2015

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“…Assessing the biomechanical properties of entire versus split dura mater, the former appears to be more fragile under stress, while the latter allows a greater volume of deformation at a lower stress level. 6 In the case series by Isu et al, all 7 patients demonstrated CM-I 13 and then underwent a suboccipital craniectomy and either a C1-2 or C-1 laminectomy, followed by removal of the outer dural layer. The authors used intraoperative ultrasonography to confirm satisfactory decompression, as visualized by the pulsation of the cerebellar tonsils after removal of the outer dural layer.…”

Section: Extradural Chiari Decompression Is a Viable And Reproduciblymentioning

confidence: 99%

Multimodal evaluation of CSF dynamics following extradural decompression for Chiari malformation Type I

Quon¹,

Grant²,

DiLuna³

2015

SPI

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OBJECT Extradural decompression is a minimally invasive technique for treating Chiari malformation Type I (CM-I) that avoids the complications of dural opening. While there is no agreement on which surgical method is optimal, mounting evidence demonstrates that extradural decompression effectively treats clinical symptoms, with a minimal reoperation rate. Neurological symptoms such as headache may be related to obstructed flow of CSF, and one aspect of successful extradural decompression is improved CSF dynamics. In this series, the authors report on their use of phase-contrast cine flow MRI to assess CSF flow as well as satisfactory decompression. METHODS The authors describe their first surgical series of 18 patients with CM-I undergoing extradural decompression and correlate clinical improvement with radiological changes. Patients were categorized as having complete, partial, or no resolution of their symptoms. Posterior fossa area, cisterna magna area, and tonsillar herniation were assessed on T2-weighted MRI, whereas improvement of CSF flow was evaluated with phase-contrast cine flow MRI. All patients received standard pre- and postoperative MRI studies; 8 (44.4%) patients had pre- and postoperative phase-contrast cine, while the rest underwent cine studies only postoperatively. RESULTS All 18 patients presented with symptomatic CM-I, with imaging studies demonstrating tonsillar herniation ≥ 5 mm, and 2 patients had associated syringomelia. All patients underwent suboccipital decompression and C-1 laminectomy with splitting of the dura. Patients with complete resolution of their symptoms had a greater relative increase in cisterna magna area compared with those with only partial improvement (p = 0.022). In addition, in those with complete improvement the preoperative cisterna magna area was smaller than in those who had either partial (0.020) or no (0.025) improvement. Ten (91%) of the 11 patients with improved flow also had improvement in their symptoms. There was 1 postoperative complication of dysphagia and dysphonia. None of the patients have required a second operation. CONCLUSIONS Extradural decompression has the potential to be the first-line treatment for CM-I but has been lacking an objective measure by which to assess surgical success as well as the need for reoperation. An increase in the CSF spaces and improved CSF dynamics may be associated with resolution of clinical symptoms. Including cine imaging as part of routine pre- and postoperative evaluation can help identify which patients are most likely to benefit from surgery.

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“…Similarly, these models are also useful in the prediction of ruptured aneurysm risk, in order to design more efficient treatment schedules (Gasser 2011). They can also help to better understand surgical techniques (Holzapfel et al 2002;Chauvet et al 2010) and thus contribute to their upgrading.…”

Section: Introductionmentioning

confidence: 99%

Affine kinematics in planar fibrous connective tissues: an experimental investigation

Jayyosi

Affagard

Ducourthial

et al. 2017

Biomech Model Mechanobiol

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The affine transformation hypothesis is usually adopted in order to link the tissue scale with the fibers scale in structural constitutive models of fibrous tissues. Thanks to the recent advances in imaging techniques, such as multiphoton microscopy, the microstructural behavior and kinematics of fibrous tissues can now be monitored at different stretching within the same sample. Therefore, the validity of the affine hypothesis can be investigated. In this paper, the fiber reorientation predicted by the affine assumption is compared to experimental data obtained during mechanical tests on skin and liver capsule coupled with microstructural imaging using multiphoton microscopy. The values of local strains and the collagen fibers orientation measured at increasing loading levels are used to compute a theoretical estimation of the affine reorientation of collagen fibers. The experimentally measured reorientation of collagen fibers during loading could not be successfully reproduced with this simple affine model. It suggests that other phenomena occur in the stretching process of planar fibrous connective tissues, which should be included in structural constitutive modeling approaches.

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Histological and biomechanical study of dura mater applied to the technique of dura splitting decompression in Chiari type I malformation

Abstract: , et al.. Histological and biomechanical study of dura mater applied to the technique of dura splitting decompression in Chiari type I malformation

Cited by 45 publications

References 46 publications

Biomimetic Microelectronics for Regenerative Neuronal Cuff Implants

Biomimetic Microelectronics for Regenerative Neuronal Cuff Implants

Multimodal evaluation of CSF dynamics following extradural decompression for Chiari malformation Type I

Affine kinematics in planar fibrous connective tissues: an experimental investigation

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