# BioGlue® Induced Mass Formation Aggravating Spinal Canal Invasion After Intradural Tumor Surgery

## TL;DR

This study found that using BioGlue® during spinal tumor surgery increases the risk of postoperative mass formation and spinal canal invasion.

## Contribution

The study identifies BioGlue® as a novel risk factor for postoperative complications after intradural spinal tumor surgery.

## Key findings

- BioGlue® use was associated with higher ESCC grades (p = 0.001).
- All five cases of symptomatic spinal canal invasion occurred in the BioGlue® group (p = 0.001).
- BioGlue® was a significant risk factor in both univariate and multivariate analyses.

## Abstract

Background/Objectives: The aim of this study was to evaluate whether the use of BioGlue® increases the risk of postoperative mass formation and subsequent spinal canal invasion after intradural spinal tumor surgery. Methods: After retrospectively reviewing patients who underwent intradural tumor surgery from 2018 to 2023, we evaluated mass formation as detected in postoperative MRI according to the Epidural Spinal Cord Compression (ESCC) grade. Patients were divided into two groups based on the use of BioGlue®, and we analyzed MRI postoperatively to compare the differences in ESCC grades and the incidence of symptomatic spinal canal invasion between the two groups. Additionally, we performed a logistic regression analysis to identify risk factors associated with mass formation and to explore their relationship with BioGlue®. Results: This study included a total of 153 patients, 87 in the BioGlue® and 66 in the non-BioGlue® groups. In the BioGlue® group, 18 patients had ESCC grade 2, and 11 had grade 3. Conversely, in the non-BioGlue® group, only 8 patients had ESCC grade 2, and none had grade 3 (p = 0.001). Among the cases of symptomatic spinal canal invasion, all five cases were identified in the BioGlue® group (p = 0.001). Both univariate and multivariate analyses showed that BioGlue® was a significant risk factor for spinal canal invasion (univariate: OR = 3.931, p = 0.005, multivariate: OR = 3.812, p = 0.003). Conclusions: Our findings indicated that BioGlue® was a significant risk factor for mass formation aggravating spinal canal invasion after intradural tumor surgery.