[Omentum transplantation to the cervical cord with microangioanastomosis]

Transplantation of omentum to the cervical cord was done in three cases with incomplete transection (Case 1) with posttraumatic progressing cervical myelopathy (Case 2) and with complete transection due to multisegmental, late cervical cord infarction (Case 3). Anastomoses were made between the occipital artery and the gastroepiploic artery of transplanting omentum and between the occipital vein and the gastroepiploic vein. In Case 2 and 3, omentum was maintained in tissue culture medium in an incubator (37 degrees C, 5% CO2) for about five hours following perfusion of the omentum with low molecular dextran containing urokinase, heparin, vitamin B12 until exploration of the dural tube and preparation of the occipital vessels were accomplished. Although complete transection with late infarct (Case 3) showed extremely slow improvement in follow-up period of 8 months, the incomplete traumatic lesions (Case 1 and 2) showed less slow but steady improvements in follow-up periods of 24 and 22 months with almost complete recovery of Case 2. Angiography showed patent anastomosis in all the cases. Dynamic CT at 4 (Case 1) and 6 (Case 2) months showed good perfusion in the compromised cord through the transplanted omentum.