Debbie Song1, Paul Park. 1. Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Abstract
STUDY DESIGN: Retrospective clinical cohort study. OBJECTIVE: To examine performance of the U-Clip for the closure of inadvertent durotomy occurring during minimally invasive spinal surgery. SUMMARY OF BACKGROUND DATA: Primary closure of inadvertent durotomies that occur during minimally invasive spinal surgery can be technically difficult to accomplish when using standard knot-tying and suture management techniques, owing to the narrow and deep surgical corridor afforded by tubular retraction systems. The U-Clip is a novel device that can achieve tight tissue approximation without the need for knot-tying and excessive suture manipulation, making it ideally suited for use in minimally invasive spinal surgeries. METHODS: We performed a retrospective review of patients who underwent minimally invasive decompressive procedures complicated by durotomy and repaired using U-Clips for the period January 2008 to January 2010. A total of seven patients were identified. RESULTS: Four of the seven patients were male. Six patients underwent lumbar laminectomy or discectomy. One patient underwent resection of a cervical synovial cyst. In each patient, the durotomy was repaired primarily using U-Clips. All six lumbar patients were discharged home on the same day, and the remaining patient was discharged the following morning. Mean follow-up was 6.3 months. No patient experienced symptoms related to persistent cerebrospinal fluid leakage. CONCLUSION: Primary closure of an inadvertent durotomy occurring during minimally invasive spinal surgery can be effectively achieved using the self-closing U-Clip device.
STUDY DESIGN: Retrospective clinical cohort study. OBJECTIVE: To examine performance of the U-Clip for the closure of inadvertent durotomy occurring during minimally invasive spinal surgery. SUMMARY OF BACKGROUND DATA: Primary closure of inadvertent durotomies that occur during minimally invasive spinal surgery can be technically difficult to accomplish when using standard knot-tying and suture management techniques, owing to the narrow and deep surgical corridor afforded by tubular retraction systems. The U-Clip is a novel device that can achieve tight tissue approximation without the need for knot-tying and excessive suture manipulation, making it ideally suited for use in minimally invasive spinal surgeries. METHODS: We performed a retrospective review of patients who underwent minimally invasive decompressive procedures complicated by durotomy and repaired using U-Clips for the period January 2008 to January 2010. A total of seven patients were identified. RESULTS: Four of the seven patients were male. Six patients underwent lumbar laminectomy or discectomy. One patient underwent resection of a cervical synovial cyst. In each patient, the durotomy was repaired primarily using U-Clips. All six lumbar patients were discharged home on the same day, and the remaining patient was discharged the following morning. Mean follow-up was 6.3 months. No patient experienced symptoms related to persistent cerebrospinal fluid leakage. CONCLUSION: Primary closure of an inadvertent durotomy occurring during minimally invasive spinal surgery can be effectively achieved using the self-closing U-Clip device.
Authors: Hormuzdiyar H Dasenbrock; Stephen P Juraschek; Lonni R Schultz; Timothy F Witham; Daniel M Sciubba; Jean-Paul Wolinsky; Ziya L Gokaslan; Ali Bydon Journal: J Neurosurg Spine Date: 2012-03-09
Authors: Tianyi Niu; Derek S Lu; Andrew Yew; Darryl Lau; Haydn Hoffman; David McArthur; Dean Chou; Daniel C Lu Journal: Global Spine J Date: 2016-04-13