Use of self-closing U-clips for dural repair in mini-invasive surgery for herniated disc

Acta Neurochir (Wien). 2008 Oct;150(10):1103-5. doi: 10.1007/s00701-008-0018-2. Epub 2008 Sep 20.

Abstract

Object: The feasibility of a new technique of dural repair (self-closing U-clips) in mini-invasive surgery for herniated disk is demonstrated in this case report.

Materials and methods: A 44-year-old male patient underwent lumbar microdiscectomy at out Institute, with subsequent dural leak as surgical complication; the dural leak re-appeared even after a second intervention in which we used muscle and dural graft and fibrin glue to repair the leak. We then decided to employ self-closing nitinol- U-clip to achieve primary dural closure.

Results: After the intervention the patient no more presented signs or symptoms due to the unintended durotomy, and the postoperative course was uneventful.

Conclusion: Self-closing nitinol U-clips (Medtronic, Inc., Minneapolis) can be used for closing a dural tear through a mini-invasive approach that could make a conventional microsuturing technique very difficult.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dura Mater / injuries
  • Dura Mater / surgery*
  • Dura Mater / transplantation
  • Fibrin Tissue Adhesive / therapeutic use
  • Humans
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / anatomy & histology
  • Lumbar Vertebrae / surgery*
  • Male
  • Microsurgery / instrumentation
  • Microsurgery / methods
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / instrumentation*
  • Neurosurgical Procedures / methods
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Postoperative Complications / surgery
  • Reoperation / instrumentation
  • Reoperation / methods
  • Surgical Instruments / standards
  • Surgical Instruments / trends*
  • Tissue Transplantation / methods
  • Treatment Outcome

Substances

  • Fibrin Tissue Adhesive