| Aneurysm clips for durotomy repair: technical note. | |
| | |
MedLine Citation:
|
PMID: 20173581 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Dural injury is a common complication of lumbar spine surgery. Primary closure is the "gold standard." OBJECTIVE: This technical note describes a failed primary closure of a durotomy revised using an aneurysm clip. METHODS: From 2005 to 2009, 5 patients underwent repair of a durotomy with the use of aneurysm clips. Resolution of the cerebrospinal fluid leak was seen in all patients. An 84-year-old woman underwent a laminectomy with an inadvertent dural tear that was primarily repaired with suture. On postoperative day 8, the patient presented with new incisional drainage. The wound was explored, and the dura had torn around the previous sutured closure. A curved aneurysm clip was used to obtain dural closure. Postoperatively, the patient's incision remained dry. RESULTS: Microsurgical closure with suture is the primary modality in durotomy repair. Difficulty arises when the dura is friable and multiple small tears are present. Suturing worsens the durotomy. Also, the durotomy is often caused along a bony edge with limited visualization, requiring additional bone removal to suture, therefore risking destabilization of the spine. CONCLUSION: We describe the application of an aneurysm clip to treat a recurrent durotomy where the standard practice of sutured closure failed. Aneurysm clips offer a quick, safe, and secure manner to close dura without risking spinal destabilization. They offer significant benefit to already torn, friable dura. Postoperatively, patients have no limitations and are therefore prevented from being exposed to additional risks associated with bed rest. Aneurysm clips are cost and clinically effective in the management of dural injuries. |
| | |
Authors:
|
Alexandra D Beier; Ryan J Barrett; Teck M Soo |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Neurosurgery Volume: 66 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Mar |
Date Detail:
|
Created Date: 2010-02-22 Completed Date: 2010-06-08 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
|
Languages: eng Pagination: E124-5; discussion E125 Citation Subset: IM |
Affiliation:
|
Providence Hospital and Medical Center, Section of Neurosurgery, Southfield, Michigan, USA. alexandra.beier@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Age Factors Aged Aged, 80 and over Dura Mater / injuries*, pathology, surgery* Female Humans Intracranial Aneurysm / surgery Laminectomy / adverse effects Lumbar Vertebrae / anatomy & histology, pathology, surgery* Male Middle Aged Neurosurgical Procedures / adverse effects* Postoperative Complications / etiology, pathology, surgery* Reoperation / methods Spondylosis / surgery Surgical Instruments / standards, trends* Suture Techniques / adverse effects |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Delineation of the nucleus centre median by proton density weighted magnetic resonance imaging at 3 ...
Next Document: The dean's 5-year calendar.