Utility of nonpenetrating titanium clips for dural closure during spinal surgery to prevent postoperative cerebrospinal fluid leakage

Journal of Neurosurgery. Spine
Kiyoshi ItoKazuhiro Hongo

Abstract

The nonpenetrating titanium clip has been successfully used in peripheral arterial bypass surgery. The purpose of this study was to evaluate the leakage pressures and patterns of nonpenetrating titanium clips using a simple model that mimicked spinal surgery. In addition, the authors describe their surgical experience with these clips and the follow-up results in 31 consecutive patients. The authors compared nonpenetrating titanium clips and expanded polytetrafluoroethylene (ePTFE) sutures in relation to the water pressure that could be tolerated by sutured ePTFE sheets, and the leakage pressure patterns were determined. The changes in leakage pressures at 5 minutes, 30 minutes, and 12 hours were examined when the clips and sutures were used in combination with the mesh-and-glue technique in an in vitro study. Thirty-one patients underwent spinal intradural procedures using nonpenetrating titanium clips to suture the dura maters using the meshand-glue technique, involving fibrin glue and polyglycolic acid-fibrin sheets. A significant difference was apparent between the ePTFE suture group and the nonpenetrating titanium clip group, with the latter showing a leakage pressure that could be sustained and was 1508% higher than that ...Continue Reading

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Citations

Feb 20, 2016·Journal of Neurosurgery. Spine·Sean M LewMarike Zwienenberg
Nov 5, 2016·Journal of Neurosurgery. Spine·Pedro David Delgado-LópezElena Araus-Galdós
Aug 16, 2016·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Soichiro MasudaShuichi Matsuda
Mar 24, 2018·Journal of Medical Engineering & Technology·Sean J NagelSaul Wilson
Feb 5, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Maximilian SitzJohannes Lemcke
Mar 1, 2021·World Neurosurgery·Elliot H ChoiMichael Y Oh

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