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


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.


CONCLUSIONS
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.
Ferroli
P
P
Fondazione Istituto Neurologico Carlo Besta, Milan, Italy. giusmex@gmail.com
Franzini
A
A
Messina
G
G
Tringali
G
G
Broggi
G
G
D000328:Adult; D004388:Dura Mater / Q000293:injuries / Q000601:surgery* / Q000637:transplantation; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013525:Surgical Instruments / Q000592:standards / Q000639:trends*; D016378:Tissue Transplantation / Q000379:methods; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive