Early application of pedicled omentum to the acutely traumatised spinal cord

Goldsmith, Harry S.; Steward, Earl; Duckett, Serge

doi:10.1038/sc.1985.18

Cited by 28 publications

(19 citation statements)

References 7 publications

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“…7± 10,13 In the ones w here delayed grafting was perform ed a noticeable lack of neurological improvem ent was observed. 13 There is no such analogy for humans as early om ental grafting has not been extensively reported. In addition, the gradual onset of gliosis following spinal cord injury m ay interfere with the success of omental grafting.…”

Section: Discussionmentioning

confidence: 98%

A critical appraisal of pediculated omental graft transposition in progressive spinal cord failure

Sgouros¹,

Williams²

1996

British Journal of Neurosurgery

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A critical review of patients who had pediculated omental grafting for progressive spinal cord failure was performed in order to assess the impact of this procedure on the natural history of the spinal cord function after spinal cord injury. Ten patients were reviewed; all had complete or partial paraplegia. Mean age at injury was 29.1 years. There was an average interval of 9.7 years between injury and onset of progressive worsening of symptoms, and 5.6 years between onset of such symptoms and diagnosis. Average follow-up was 24.5 months. Five patients underwent omental grafting as primary surgical treatment whereas the other five had earlier procedures. One patient died on the postoperative period. Significant morbidity was also observed. All the surviving patients were asked to score themselves by answering a questionnaire exploring the effect of surgery in limb function and performance on activities of daily living. Only two patients improved following the procedure. Two others remained unchanged, while the remaining six continued to deteriorate. There was no difference in clinical outcome between the primary surgery group and the ones that had had previous procedures. Delayed omental grafting done as tried in this clinic did not seem to improve the prognosis of the injured cord and was associated with significant morbidity.

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Section: Discussionmentioning

confidence: 98%

A critical appraisal of pediculated omental graft transposition in progressive spinal cord failure

Sgouros¹,

Williams²

1996

British Journal of Neurosurgery

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“…Yeo's work on hyperbaric oxygen therapy is another likely contender (Yeo et al, 1976). Procedures to improve the circulation in the region of the graft, such as Goldsmith's omental grafting technique, may also prove to be beneficial (Goldsmith et al, 1982).…”

Section: Discussionmentioning

confidence: 99%

Peripheral nerve implants in the spinal cord in experimental animals

Wilson

1984

Spinal Cord

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SUIDIDary. This paper challenges the concept of 'spinal cord autotomy' as an essential process which will prevent the penetration of spinal cord fibres into a peripheral nerve implant.It proposes that mechanical distraction between the graft and the cord is the main reason why spinal cord fibres fail to traverse a graft. Clinical, neurophysiological and histological evidence is presented to show that embedding an autogenous peripheral nerve implant into a trough in the dorsal half of the cord is effective in restoring continuity in some of the long fibre tracts. Reference is made to other recent work which supports these observations. Possible methods of enhancing the number of fibres which traverse the graft are discussed and an attempt is made to anticipate the possible results of the clinical application of this technique in spinal cord injury patients.

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“…shown to protect the brain and spinal cord from the effects ofischaemia and trauma in various experimental studies in animals 4,8,9,11,13,17,23. This procedure has also been used to treat fixed deficits after cerebral ischaemia and spinal cord trauma in humans 2 ' 16, 18, 22 In addition to these common indications, omental transposition to the brain and spinal cord has been done for a number of other disease processes 1 ' 6, 19.…”

Section: Omental Transposition or Transplantation Has Beenmentioning

confidence: 99%

Acute effects of a pedicled omental graft on cold-induced brain oedema in cats

1991

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When used as a prophylactic measure and in chronic experiments, omental transposition has been shown to reduce ischaemic and traumatic oedema in the spinal cord and ischaemic oedema in the brain. We designed this experiment to evaluate the acute effects of a pedicled omental graft on cold-induced brain oedema in cats. Focal oedema was induced in the left frontoparietal region of the brain of nine anaesthetized cats. In five cats, a laparotomy was done and a pedicled omental graft was placed on the lesioned left hemisphere immediately after the cold lesion was made. All cats were sacrificed 72 hours later, and the water content of the white matter was determined in the lesioned and the normal hemispheres. The mean water content of the lesioned hemisphere of the treated group of animals was not significantly different from that of the control group. We conclude that a pedicled omental graft failed to reduce vasogenic oedema in an acute model and probably has no role in the acute management of brain oedema.

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Early application of pedicled omentum to the acutely traumatised spinal cord

Cited by 28 publications

References 7 publications

A critical appraisal of pediculated omental graft transposition in progressive spinal cord failure

A critical appraisal of pediculated omental graft transposition in progressive spinal cord failure

Peripheral nerve implants in the spinal cord in experimental animals

Acute effects of a pedicled omental graft on cold-induced brain oedema in cats

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