P.211 Characterizing and comparing brain injury associated with traditional self-retracting brain retractors with novel tubular retractors. (November 2021)

• Record Type: Journal Article
• Authors: Naeem, A; Dryden, G; Hammond, R; Speechley, M; Wade, K; Boulton, M
• Is Part Of: Canadian journal of neurological sciences. Volume 48(2021)Supplement S3
• Page Start: S80
• Page End: S81
• Publication Date: 2021-11
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Electronic journals; 616.8
• DOI: 10.1017/cjn.2021.487
• Languages: English
• ISSNs: 0317-1671

Abstract

Abstract : Background: Tubular retractors are FDA approved and in the Neurosurgical marketplace, but adaptation has been hampered by lack of evidence showing superiority over traditional retractors when performing subcortical surgery. This study examines brain injury associated with traditional brain retractors versus tubular retractors. Methods: Nine porcine models underwent a simulated neurosurgical operation. Retractors were inserted for four hours after which the porcine model was euthanized. The en-bloc extracted porcine brain was fixed in 10% formalin, paraffin embedded, sectioned at 4 um and stained with hematoxylin and eosin (H&E) using standard laboratory protocols. Computer algorithms were generated to calculate areas of cerebral edema and hemorrhage adjacent to retractor surfaces. Results: Using a two-tailed t-test with a significance level of 0.05, traditional brain retractors were associated with statistically significant greater areas of cerebral edema when compared to tubular retractors (17.36 um 2 vs. 12.42 um 2 ; p = 0.0038). There was no statistically significant difference in mean areas of hemorrhage between traditional brain retractors and tubular retractors (3.43 um 2 vs 3.60 um 2 ; p = 0.8297). Conclusions: Tubular retractors are associated with significantly less edema in surrounding brain than traditional retractors. On histopathological merits, this study supports the application of tubular retractors over traditional retractors.