Results of a Bioresorbable Hydrogel Sheet Utilized as an Adhesion Barrier in Spine Surgery - Abstract
Background/Intro: Scar tissue following spine surgery is expected, but hypothesized to be related to complications such as incidental durotomy, vessel injury, further increase in scar tissue formation, failed back surgery syndrome, and diminished patient outcomes. Scar tissue prevention remains elusive, but advancements in adhesion barriers have shown compelling results in minimizing complications. Methods: A retrospective review of one orthopedic surgeon’s patients that received VersaWrap (VW) during spine surgery. VW is a bioresorbable hydrogel sheet made of polysaccharides alginate and hyaluronic acid designed to separate tissues, allow gliding and prevent tethering. Pre-operative demographics, surgical details, patient reported outcomes, complications, and reoperations were collected and analyzed for all patients. Statistical analysis was completed on the appropriate data using a paired t-test. Results: Data for 169 patients that received posterior lumbar decompression were collected and analyzed. Patient reported outcomes showed significant improvement (p<0.05) in mean scores from pre-operative to 3-month follow-up for Visual Analogue Scale (VAS) neck/arm, VAS back/leg, NDI, and ODI. Four complications were reported, all peri-operative incidental durotomies that were repaired during surgery with no lasting impacts. Eleven patients underwent reoperations, unrelated to VW, but allowed for visual inspection of the VW post-operatively. Conclusion: The use of VW during spine surgery appears to reduce potential complications from scar tissue formation, specifically in the event a reoperation occurs in the same anatomic region. There are limitations to this study, including that it is retrospectively collected, but exploration of adhesion barriers in spine surgery applications appear promising and warrant further study.