{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:49:02Z","timestamp":1788263342722,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,10,29]],"date-time":"2012-10-29T00:00:00Z","timestamp":1351468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2012,11]]},"abstract":"Objective<\/jats:title>To study the therapeutic efficacy of the \u201csandwich\u201d method (medical glue\u2009+\u2009gelatin sponge\u2009+\u2009medical glue) of spinal dural repair for preventing cerebrospinal fluid (CSF<\/jats:styled-content>) leaks during treatment of subdural tumors.<\/jats:p><\/jats:sec>Methods<\/jats:title>Fifty\u2010four patients with spinal subdural tumors treated between A<\/jats:styled-content>pril 2007 and J<\/jats:styled-content>une 2011 were retrospectively investigated. The patients were divided into two groups: a conventional group (G<\/jats:styled-content>roup A) and a \u201csandwich\u201d group (G<\/jats:styled-content>roup B<\/jats:styled-content>). The G<\/jats:styled-content>roup A<\/jats:styled-content> patients included 16 males and 7 females with an average tumor course of 11 months (range, 2\u201334 months). Four of their 23 tumors were in the cervical spine, eight thoracic, and eleven lumbar. The G<\/jats:styled-content>roup B<\/jats:styled-content> patients included 19 males and 12 females with an average tumor course of 12 months (range, 3\u201336 months). Five of their 31 tumors were in the cervical spines, 10 thoracic, and 16 lumbar. In G<\/jats:styled-content>roup A<\/jats:styled-content>, the dural repairs were performed with interlocking sutures and a gelatin sponge covering the dura; whereas in G<\/jats:styled-content>roup B<\/jats:styled-content>, they were performed with interlocking sutures, painting of medical glue around the dural incision, covering this with a gelatin sponge, and finally covering of the gelatin sponge with medical glue. The total volume of drainage after operation, incidence of CSF<\/jats:styled-content> leaks, healing of the incision, and recovery of clinical performance were recorded.<\/jats:p><\/jats:sec>Results<\/jats:title>Compared to G<\/jats:styled-content>roup A<\/jats:styled-content> patients, G<\/jats:styled-content>roup B<\/jats:styled-content> patients had a significantly smaller total volume of drainage (P<\/jats:styled-content><\/jats:italic> < 0.05) on the day of surgery, and the first, second, and third postoperative days. The incidence of CSF<\/jats:styled-content> leakage in G<\/jats:styled-content>roup B<\/jats:styled-content> was also significantly less than in Group A<\/jats:styled-content> (P<\/jats:styled-content><\/jats:italic> < 0.05). Before discharge, three patients in Group A developd hydrops, which was successfully treated by aspiration, continuous pressure from sandbags, and the prone position. During the first 3 months of follow\u2010up, five patients developed deep hydrops under their incisions but required no treatment. There were no obvious abnormalities in G<\/jats:styled-content>roup B<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>After removal of subdural spinal tumors by incising the dura mater, or in related spinal surgery, application of the \u201csandwich\u201d complex to the damaged spinal dura reduces the volume of drainage postoperatively and reduces the incidence of CSF<\/jats:styled-content> leakage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12005","type":"journal-article","created":{"date-parts":[[2012,10,29]],"date-time":"2012-10-29T16:58:34Z","timestamp":1351529914000},"page":"233-240","source":"Crossref","is-referenced-by-count":12,"title":["A Comparison between \u201cSandwich\u201d and Conventional Methods of Repairing Spinal Dura Rupture"],"prefix":"10.1111","volume":"4","author":[{"given":"Hui\u2010ren","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Zhongshan Hospital Fudan University Shanghai 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