1. Spinal dura mater: biophysical characteristics relevant to medical device development
- Author
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Leonardo A. Frizon, Matthew A. Howard, George T. Gillies, Chandan G. Reddy, Sean J. Nagel, Matthieu K. Chardon, Saul Wilson, Marshall T. Holland, and Andre G. Machado
- Subjects
musculoskeletal diseases ,Medical device ,Dura mater ,Biomedical Engineering ,Spinal dura mater ,Spinal cord stimulation ,Intrathecal ,Article ,03 medical and health sciences ,0302 clinical medicine ,Spine surgery ,Tensile Strength ,medicine ,Humans ,Tubular membrane ,integumentary system ,business.industry ,General Medicine ,musculoskeletal system ,Electric Stimulation ,Spine ,Improved performance ,medicine.anatomical_structure ,nervous system ,Spinal Cord ,030220 oncology & carcinogenesis ,Dura Mater ,business ,030217 neurology & neurosurgery ,Biomedical engineering - Abstract
Understanding the relevant biophysical properties of the spinal dura mater is essential to the design of medical devices that will directly interact with this membrane or influence the contents of the intradural space. We searched the literature and reviewed the pertinent characteristics for the design, construction, testing, and imaging of novel devices intended to perforate, integrate, adhere or reside within or outside of the spinal dura mater. The spinal dura mater is a thin tubular membrane composed of collagen and elastin fibres that varies in circumference along its length. Its mechanical properties have been well-described, with the longitudinal tensile strength exceeding the transverse strength. Data on the bioelectric, biomagnetic, optical and thermal characteristics of the spinal dura are limited and sometimes taken to be similar to those of water. While various modalities are available to visualise the spinal dura, magnetic resonance remains the best modality to segment its structure. The reaction of the spinal dura to imposition of a foreign body or other manipulations of it may compromise its biomechanical and immune-protective benefits. Therefore, dural sealants and replacements are of particular clinical, research and commercial interest. In conclusion, existing devices that are in clinical use for spinal cord stimulation, intrathecal access or intradural implantation largely adhere to traditional designs and their attendant limitations. However, if future devices are built with an understanding of the dura's properties incorporated more fully into the designs, there is potential for improved performance.
- Published
- 2018