Reducing complications in duraplasty with autologous dural graft material: A meta-analysis.

Abstract

Objective: This review aims to perform qualitative and quantitative analysis to determine which dural graft materials are preferable for neurosurgical patients.

Methods: A literature search using the PubMed database was conducted to collect relevant articles that compared complications associated with autologous and non-autologous dural grafts. The extracted data included graft type and related complications. Screening of all studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Statistical tests were conducted using Microsoft Excel to compare categorical variables, and data analysis was performed using Review Manager 5.4.1.

Results: A total of twelve studies were deemed eligible from 1,646 articles. These studies included 1,877 patients; 965 (51.4%) received autologous grafts and 912 (48.6%) received non-autologous grafts. Pooled data from autologous grafts showed significant reductions in meningitis (OR=0.31; 95% CI 0.17-0.54), pseudomeningocele (OR=0.50; 95% CI 0.32-0.79), and wound infection rates (OR=0.34; 95% CI 0.14-0.80) compared to the non-autologous group. There were no significant differences in cerebrospinal fluid (CSF) leakage, hydrocephalus, or revision surgery rates.

Conclusions: Autologous dural grafts are more effective compared to non-autologous grafts in reducing the incidence of meningitis, pseudomeningocele, and wound infections following duraplasty. However, the risks of CSF leakage, hydrocephalus, and revision surgery are similar for both graft types.